50 year old female who was not aware of the diagnosis of diabetes mellitus applied to ophthalmology clinic due to the decreased vision in her right eye.
In fundus images, widespread disc and retinal neovascuarization are seen and fundus fluorescein angiography showed the leakage from neovascularization in addition to large areas of peripheral and central non-perfusion.
Diabetic retinopathy can be the first manifestation of diabetes mellitus. Proliferative diabetic retinopathy (PDR) is the most serious complication of diabetic retinopathy and can lead to vision loss. PDR is characterised by the presence of abnormal new blood vessels, either on or within one disc diameter of the optic disc (NVD) or elsewhere in the retina (NVE). High-risk PDR is characterized by NVD greater than one-fourth to one-third disc area in size; any NVD with a vitreous or preretinal hemorrhage; or NVE greater than one-half a disc area in size with a vitreous or preretinal hemorrhage. In severe cases, fibrovascular membranes grow over the retinal surface and tractional retinal detachment with sight loss can occur, despite treatment.
Diabetic retinopathy, and even, PDR can be the first manifestation of diabetes mellitus.
Credit: Kemal Tekin, M.D., from Ulucanlar Eye Training and Research Hospital
Instagram accounts: @retina.academy and @dr.kemaltekin
Color fundus image of the right eye of a patient with proliferative diabetic retinopathy.
Wide-field fundus image of the right eye of a patient with proliferative diabetic retinopathy.
Color fundus image of the left eye of a patient with proliferative diabetic retinopathy.
Wide-field fundus image of the left eye of a patient with proliferative diabetic retinopathy.
Wide-field fundus fluorescein angiography of the right eye of a patient with proliferative diabetic retinopathy.
Wide-field fundus fluorescein angiography of the left eye of a patient with proliferative diabetic retinopathy.
Optical coherence tomography of the right eye of a patient with proliferative diabetic retinopathy. 
Optical coherence tomography angiography of the left eye of a patient with proliferative diabetic retinopathy.
