Question

Diabetic ischemic maculopathy is characterized by all of the following except?

• A. It occurs due to microvascular blockage
• B. Mild visual loss
• C. Areas of non-perfusion are evident on fluorescein angiography
• D. Microaneurysms and hemorrhages are seen

Hint:

Foveal ischaemia kills central acuity, so visual loss is marked, not mild.

Answer 1

The Correct Option is B

Step 1: Ischaemic diabetic maculopathy results from microvascular blockage at the macula, so retinal capillaries that should perfuse the fovea are occluded.

Step 2: Clinically it causes marked, not mild, visual loss because the central retina is deprived of blood. It is accompanied by microaneurysms, haemorrhages, only mild or no macular oedema, and a few hard exudates.

Step 3: Fluorescein angiography is diagnostic and shows areas of non-perfusion, beginning as enlargement of the foveal avascular zone, then capillary dropout, and in advanced cases blocked precapillary arterioles.

Step 4: The question asks for the false statement. Microvascular blockage, non-perfusion on angiography, and microaneurysms with haemorrhages are all true. The visual loss is marked, not mild, so mild visual loss is the exception and the correct answer.