Question 1: In diabetes mellitus the following findings are seen in ophthalmoscopy except:
- A. Flame shaped haemorrhage
- B. Dot haemorrhage
- C. Wet sponge haemorrhage (Correct Answer)
- D. Microaneurysm
Explanation: ***Wet sponge haemorrhage***
- **Wet sponge haemorrhage** is not a term typically used in the description of diabetic retinopathy or other retinal conditions found during ophthalmoscopy.
- The appearance it suggests (diffuse, sponge-like bleeding) does not correlate with the characteristic hemorrhage types seen in diabetic retinopathy.
- This is **not a recognized ophthalmologic finding** in diabetes mellitus.
*Flame shaped haemorrhage*
- **Flame-shaped haemorrhages** are superficial retinal hemorrhages in the nerve fiber layer, commonly seen in diabetic retinopathy as well as hypertensive retinopathy.
- Their characteristic shape reflects the arrangement of nerve fibers in the retina.
- These are seen in both non-proliferative and proliferative diabetic retinopathy.
*Dot haemorrhage*
- **Dot haemorrhages** are small, round hemorrhages located deeper in the retina (inner nuclear and outer plexiform layers).
- These are a common early finding in diabetic retinopathy, often representing microaneurysms that have ruptured or deep intraretinal hemorrhages.
- They indicate damage to retinal capillaries.
*Microaneurysm*
- **Microaneurysms** are the earliest and most characteristic clinical sign of diabetic retinopathy, appearing as small, red dots on the retina.
- They represent focal outpouchings of retinal capillaries due to weakened vessel walls and pericyte loss.
- Best visualized with fluorescein angiography but visible on ophthalmoscopy.