A 55-year-old patient with longstanding diabetes develops a new onset of blurred vision in the right eye. Fundus examination shows a microaneurysm at the foveal center and hard exudates forming a circinate ring around the macula. OCT confirms macular thickening. This represents:

• A Non-proliferative diabetic retinopathy (NPDR) without clinically significant macular oedema
• B Proliferative diabetic retinopathy with macular traction
• C Central serous chorioretinopathy
• D Clinically significant macular oedema (CSMO) requiring treatment ✓

Explanation

Clinically significant macular oedema (CSMO) is defined by the ETDRS criteria as retinal thickening within 500 µm of the foveal center, hard exudates within 500 µm of the center with adjacent thickening, or a zone of thickening ≥1 disc diameter within 1 disc diameter of the center. This patient meets the first criterion (foveal microaneurysm with macular thickening confirmed on OCT). CSMO is an indication for treatment regardless of the degree of NPDR; first-line treatment is intravitreal anti-VEGF therapy or focal/grid laser photocoagulation.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.