This 51YO female with type 2 diabetes presented with severe peripheral proliferative diabetic retinopathy (PDR).
Despite having extensive angiographic neovascularization encircling each posterior pole, these findings are remarkably less obvious on color imaging.
Learning Points:
These types of presentations are very humbling to us clinicians and remind us of the importance of peripheral retinal examination and ultra-widefield imaging with fluorescein angiography in screening for proliferative disease.
Widefield OCT angiography may also prove to be an equally effective yet less invasive screening tool (Al-Khersan et al., Am J Ophthalmol 2021;224:292-300).

