Saw a 38 yo male patient in late October who is a high myope and diabetic( form 2) whose refraction has been fairly stable over the past few quizs( about -9. 50/ -1. 50 OD, -7. 50 OS) and has had good verify over his diabetes with meds. I’ve been dilating him annually and there has been no sign of any diabetic retinopathy or edema. Nonetheless he came in Wednesday with complaints of blur over the last week, especially on the right eye.
Refraction had dropped to -7. 50 OD and -6. 25 OS with BCVA of 20/20. This kind of change formed me believe diabetic macular edema, but maculas looked flat with a insignificant foveal reflex. In addition he has had a big nutrition transformation( removing processed foods and sweets, exercising, etc) and lost 40 lbs in the last couple of months. He’s due for another q3mo HbA1C, but that isn’t booked until January. I’ve written him a brand-new drug and set up a referral to an ophthalmologist, but will be getting him a macular OCT and watching closely.
Have any of you check a alter like this from weight loss? Quick research found that significant hyperopic switches were discovered in gastric bypass surgery patients, but that is pretty brand-new( Chaichian et al, 2018) and hasn’t actually been discussed beyond that observational newspaper as far as I can tell.
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