A 45-year-old man with a history of diabetes and hypertension complains of gradual loss of vision in both eyes over the past few months. He reports difficulty reading, particularly in low light. On fundoscopy, there are hard exudates, microaneurysms, and dot-blot hemorrhages. What is the most likely diagnosis? A) Age-related macular degeneration B) Diabetic retinopathy C) Retinal vein occlusion D) Cataract E) Glaucoma Correct Answer: B) Diabetic retinopathy Explanation: Diabetic retinopathy is characterized by hard exudates, microaneurysms, and dot-blot hemorrhages on fundoscopy, and is the most common cause of gradual vision loss in diabetic patients. Age-related macular degeneration (A) typically presents with central vision loss and drusen (yellow deposits) in the macula, not the vascular changes seen in diabetic retinopathy. Retinal vein occlusion (C) presents with blurry vision and flame-shaped hemorrhages, but the findings are often localized to a quadrant of the retina. Cataract (D) causes gradual vision loss but is usually associated with blurry vision and glare, rather than the specific retinal findings seen here. Glaucoma (E) presents with peripheral vision loss and optic disc cupping, not the retinal findings described in this patient. Key Tips for PLAB 1: ✅ Hard exudates, microaneurysms, and dot-blot hemorrhages = Diabetic retinopathy ✅ Management = Blood sugar and blood pressure control, regular eye screening for diabetes
