case_images: PMC10963054_01
case_images: Findings at first consultation and day 14. a, b At first consultation, fundus examination revealed multiple scattered retinal hemorrhages and hard and soft exudates in both eyes. c, d OCT revealed macular edema and subretinal fluid in both eyes. e, f On day 14, fundus examination showed that the retinal hemorrhage was reduced in both eyes.
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case_images: F1
case_images: However, fundus examination revealed multiple scattered retinal hemorrhages and hard and soft exudates in both eyes; then he was diagnosed with PPDR (shown in Fig. 1a, b). Additionally, optical coherence tomography (OCT) imaging showed macular edema and subretinal fluid in both eyes (shown in Fig. 1c, d). Subsequent fundus examination revealed a reduction in retinal hemorrhage in both eyes (shown in Fig. 1e, f).
case_images: Findings on days 88, 132, and 181. a On day 88, a fresh retinal hemorrhage was observed in the right eye. b No remarkable changes were observed in the retina of the left eye. c, d On day 132, the retinal hemorrhage worsened, and a new preretinal hemorrhage was observed in both eyes. e, f On day 181, the retinal hemorrhage improved in both eyes after roxadustat was discontinued and switched to darbepoetin alfa.
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case_images: F2
case_images: By day 88 (14 days after the start of roxadustat), there was no notable change in the retina of the left eye, whereas a fresh retinal hemorrhage was observed in the right eye (shown in Fig. 2a, b). On day 132 (58 days after the start of roxadustat), the retinal hemorrhage worsened further, and a new preretinal hemorrhage was observed in both eyes (shown in Fig. 2c, d). By day 181 (49 days after the cessation of roxadustat), there was an improvement in the retinal hemorrhage (Fig. 2e, f).
case_images: Findings at day 201. a, b Fundus hemorrhage had further improved in both eyes. c, d OCT showed no macular edema or subretinal fluid, and the retina was generally thin. e, f Fluorescein angiography revealed multiple neovascular vessels, active leakage of fluorescein, and extensive avascular areas in both eyes.
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case_images: F3
case_images: Fig. 3a-d). Fluorescein angiography, however, indicated the presence of multiple neovascular vessels, active fluorescein leakage, and extensive avascular areas in both eyes (shown in Fig. 3e, f).