Diabetic retinopathy is the most common cause of legal blindness in persons
between the ages of 20 and 65 years. In this 56-year-old man with a 20-year
history of type 2 diabetes, multiple, scattered intraretinal (dot-blot) hemorrhages
and superficial nerve fiber layer (splinter) hemorrhages can be seen.
An occasional Roth spot--an intraretinal hemorrhage with a white center that
represents a fibrin thrombus which occludes a ruptured blood vessel--is also
evident. Numerous yellow, waxy, hard exudates are seen between the inner
plexiform and inner nuclear layers of the retina. Cotton-wool spots are also
present, although no neovascularization is present.
Patients with diabetes need to have their eyes examined by an ophthalmologist
at least yearly to monitor for ocular complications.
(Case and photo courtesy of Leonid Skorin, Jr, DO.)