Question:medium
An elderly woman presented with gradual painless diminution of vision. The fundus picture is shown below (yellowish-white deposits around the macula). What is the diagnosis?
An elderly woman presented with gradual painless diminution of vision. The fundus picture is shown below (yellowish-white deposits around the macula). What is the diagnosis?
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Yellowish waxy deposits with well-defined edges around the macula in a diabetic patient represent lipid-laden hard exudates.
Updated On: Jun 23, 2026
- Hard Exudates in Diabetic Retinopathy
- Flame shaped haemorrhages in Hypertensive Retinopathy
- Soft Exudates in Hypertensive Retinopathy
- CRVO (Central Retinal Vein Occlusion)
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The Correct Option is A
Solution and Explanation
The fundus shows yellowish-white, well-defined deposits around the macula in an elderly woman with gradual painless visual loss.
These are hard exudates -- the hallmark of diabetic maculopathy.
Composition: lipid and lipoprotein deposits that leak from damaged retinal capillaries and accumulate in the outer plexiform layer.
Appearance: bright yellow, waxy, well-defined edges; often arranged in a circinate (ring) pattern around foci of leaking microaneurysms.
Clinical significance: hard exudates at or near the fovea indicate clinically significant macular oedema (CSME) -- a sight-threatening complication of diabetic retinopathy. Large deposits can lead to subretinal fibrosis, one of the most devastating sequelae of diabetic maculopathy.
Distinguishing features:
- Soft exudates (cotton-wool spots): fluffy white, ill-defined -- nerve fibre layer infarcts in hypertension
- Flame haemorrhages: red streaks -- hypertensive retinopathy
- CRVO: "blood and thunder" fundus with haemorrhages in all 4 quadrants \[\boxed{\text{Hard Exudates in Diabetic Retinopathy}}\]
These are hard exudates -- the hallmark of diabetic maculopathy.
Composition: lipid and lipoprotein deposits that leak from damaged retinal capillaries and accumulate in the outer plexiform layer.
Appearance: bright yellow, waxy, well-defined edges; often arranged in a circinate (ring) pattern around foci of leaking microaneurysms.
Clinical significance: hard exudates at or near the fovea indicate clinically significant macular oedema (CSME) -- a sight-threatening complication of diabetic retinopathy. Large deposits can lead to subretinal fibrosis, one of the most devastating sequelae of diabetic maculopathy.
Distinguishing features:
- Soft exudates (cotton-wool spots): fluffy white, ill-defined -- nerve fibre layer infarcts in hypertension
- Flame haemorrhages: red streaks -- hypertensive retinopathy
- CRVO: "blood and thunder" fundus with haemorrhages in all 4 quadrants \[\boxed{\text{Hard Exudates in Diabetic Retinopathy}}\]
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