Red Dots - Microaneurysms
● Microaneurysms are usually the first ophthalmoscopically detectable sign of diabetic retinopathy
● Hallmark of nonproliferative diabetic retinopathy (NPDR)
● Mild NPDR- Microaneurysms only
● Also seen in - retinal vein occlusions, radiation retinopathy, hypertensive retinopathy
𝐏𝐚𝐭𝐡𝐨𝐥𝐨𝐠𝐲:
● Focal saccular outpouchings of the capillary wall due to pericyte loss
● Arise from deep part of inner retinal capillary plexus, and are present in the inner nuclear layer
𝐅𝐞𝐚𝐭𝐮𝐫𝐞𝐬:
● Appear as small round red dots - usually seen at the posterior pole, especially temporal to fovea
● 10- 100 microns in diameter
● Only > 30 microns is visible ophthalmoscopically (better on red free illumination)
● < 30 microns can be seen on FFA and hence more microaneurysms are seen on FFA than fundus
● Hyperfluroscent with late leakage on FFA
Image from Rajan Eye Care Hospital
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