This is the commonest cause of visual impairment in diabetics. It occurs more commonly in type II diabetics. Three types of maculopathy are known and these can occur in isolation or in combination with each other. The three types are:
• Focal caused by focal leakage from a micro-aneurysm or dilated capillaries and surrounding exudates are seen (Figure 21.5).
• Diffuse oedema caused by diffuse leakage from dilated capillaries at the posterior
pole of the eye. Retinal oedema is diffuse and can be associated with microaneurysms and few haemorrhages but exudates are absent (Figure 21.6).
• Ischaemic maculopathy is caused by closure of the perifoveal and surrounding vascular network. In addition to diffuse oedema, several dark haemorrhages might be present (Figure 21.7a). Fluorescein angiography might be required to confirm the ischaemia and determine its severity (Figure 21.7b).
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