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Diabetic macular oedema — SCE Endocrinology MCQ

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HardDiabetes complicationsDiabetic macular oedemaSCE Endocrinology

A 52-year-old woman with type 2 diabetes reports gradual central visual distortion. Retinal photography shows hard exudates and thickening within one disc diameter of the fovea. Peripheral laser scars from previous proliferative disease are present. What is the most appropriate management?

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Correct answer: C — Urgent referral for ophthalmology assessment and intravitreal anti-VEGF consideration

Urgent referral for ophthalmology assessment and intravitreal anti-VEGF consideration is best because fovea-threatening diabetic macular oedema requires specialist ophthalmology assessment, often with intravitreal therapy. The alternatives are less appropriate because routine recall risks vision loss; glucose optimisation alone is not acute ocular therapy; carbimazole is unrelated; antibiotics do not treat macular oedema. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: NICE diabetic eye disease guidance