Diabetic maculopathy

Clinically significant macular oedema.

Diabetic maculopathy treated with argon laser.
Note: This is a very popular case, you must demonstrate to the examiner(s) that you know what is meant 
by significantly macular oedema (this is done through physical examination and not fluorescein angiography). 
The maculopathy may occur in background diabetic retinopathy or in association with preproliferative or 
proliferative diabetic retinopathy. The clinical appearance of the maculopathy alone cannot distinguish between 
ischaemic from non-ischaemic maculopathy.

There are multiple dot and blot haemorrhages, microaneurysms and  hard exudates (which may be circinate and 
form around a leaking microaneurysm). The presence of macula oedema is regarded as clinically significant if:

a. retinal thickening at or within 500um of the centre of the macula
b. hard exudates at or within 500um of the macular centre if associated with thickening of the 
    adjacent retina
c. retinal thickening at least one disc area in extent, any part of which is within one disc diameter of the 
    macular centre.


1. What is the most common cause of visual loss in diabetic retinopathy?

2. Is fluorescein angiography essential in deciding treatment for diabetic maculopathy?

3. What are the results of ETDRS (Early Treatment of Diabetic Retinopathy Study) with regard to treatment of clinically significant macular oedema?

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