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A 42-year-old male presents with a slowly progressive decrease in vision for the past 1-2 years. Past medical history is significant for diabetes and hypertension. His medications are glipizide, metformin, lisinopril, hydrochlorothiazide and amlodipine. He has no known past ocular history. BCVA is 20/150 and 20/100 in the right and left eyes, respectively. Anterior segment exam is notable only for trace nuclear sclerosis in both eyes. Fundus exam shows macular hard exudates, attenuated vasculature and scattered microaneurysms in the periphery of both eyes. A late frame from the fluorescein angiogram (FA) of both eyes is shown above.

5 comments

  1. I really enjoy these quizzes and would really like it if these were on a weekly basis. Excellent learning fascillity in general. Thank tou

  2. Disagree with no. 3. Repeated injections do not work!.
    Injection and laser are needed here to reduce progression of maculopathy and also because of NVE

    1. We agree. The explanatory answer to question number 3 states that injection followed by laser is the treatment of choice. The answer is NOT suggesting repeated injections as a sole treatment.

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