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A Case of Diabetes Mallitus Following Diabetic Retinopathy and Nephropathy with Normal Blood Test
Ann Optom Contact Lens 2018;17:14-17
Published online March 25, 2018
© 2018 The Korean Optometry & Contact Lens Study Society

Jae Hyuk Kim MD1, Hyeong Ju Kwon MD, PhD2, Sun Woong Kim MD, PhD1

Department of Ophthalmology, Yonsei University Wonju College of Medicine1, Wonju, Korea
Department of Pathology, Yonsei University Wonju College of Medicine2, Wonju, Korea
Correspondence to: Sun Woong Kim, MD, PhD
Department of Ophthalmology, Yonsei University Wonju College of Medicine, #20 Ilsan-ro, Wonju 26426, Korea
Tel: 82-33-741-1346, Fax: 82-33-741-0460
E-mail: eyedockim@yonsei.ac.kr
Received December 14, 2017; Revised January 16, 2018; Accepted January 22, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: To report a case of diabetic mellitus following diabetic retinopathy and diabetic nephropathy in a patient with no history of previous diabetes mellitus and no evidence of diabetes in the blood test.
Case summary: A 39-year-old man with no previous history of diabetes mellitus was referred to our clinic for further diagnosis because of suspected diabetic nephropathy. No specific findings on the anterior segment were found on slit lamp microscopy. Fundus examination revealed flame-shaped retinal hemorrhages and cotton wool spots around optic disc and macula in both eyes. No other specific findings were observed. Urine glucose was not detected in the urine test at admission and glucose was normal in the blood test. The hemoglobin A1c (HbA1c) test was normal in 5.8. Diabetic retinopathy was diagnosed by fundus examination, and diabetes was confirmed by oral glucose tolerance test (OGTT test).
Conclusions: Although the patient was not aware of the presence of diabetes, diabetic retinopathy was often diagnosed by fundus examination. In this case, diabetic retinopathy was diagnosed by fundus examination after suspicion of diabetes through renal biopsy in the absence of diagnosis of diabetes in internal medicine. After all, diabetes could be diagnosed in internal medicine conversely. It can be reemphasized once again how important it is to perform fundus examination early in diagnosing diabetic patients.
Keywords : Diabetic retinopathy; Diabetes mellitus; Diabetic nephropathy; Oral glucose tolerance test


June 2018, 17 (2)