Fundus Image

Fundus exam showed non-proliferative diabetic retinopathy along with hard exudates, central diabetic macular edema, intraretinal blood, and patches of RPE atrophy as a result of previous laser treatment.

Fundus image shows diabetic macular edema with focal atrophy post focal laser treatment

Optical coherence tomography

OCT scan shows increased central retinal thickness, with the cystic formation in the inner retinal tissues with hyperreflective foci presenting hard exudates and RPE atrophy induced by laser photocoagulation treatment.

OCT cross-section showing centra DME with non-central RPE atrophy

Discussion

This patient has good BCVA 20/32 despite RPE atrophy's presence because of its location away from FAZ.

This patient was managed as central DME with monthly intravitreal injection of AntiVEGF.

Please check clinical guidelines in diabetic retinopathy

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RPE atrophy post-laser treatment discussion