Case 31

Contributor: Dr. Sultan Aldrees, MD

Patient Presentation: A 57-year-old male diagnosed with diabetes mellitus (DM) presented to clinic for a routine eye exam. His vision was 20/25 OD and 20/30 OS. His intraocular pressures were normal, and his slit lamp exam was unremarkable. Dilated fundus exam showed moderate non-proliferative diabetic retinopathy (NPDR). 

Question: Given the clinical history, what does the hyper-fluorescent lesion in the OCT photo (left) likely represent?

Question: Which layer are hard exudates usually located in:

Question: What other additional features are present in the OCT photo:

Question: Can you list the criteria for defining clinically significant macular edema (CSME) as established by the Early Treatment for Diabetic Retinopathy Study (ETDRS) study?

Question: What is the differential diagnosis for lesions that can lead to hard exudate?

Learning Objectives:

1. To understand some of the OCT findings in diabetic retinopathy

2. To recognize the OCT appearance of hard exudates

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