摘要： Proliferative diabetic retinopathy is characterised by the growth of neovascular tissue, which almost always occurs at the optic disc and/or near the major nasal and temporal vascular arcades, sparing the foveal area.1 Finkelstein et al. ?rst described neovascular frond at the fovea arising from the perifoveal capillaries.2 A few other authors like Joondeph et al., Kurz et al., Rajagopal et al. and Seth et al. have also reported similar ?ndings.3–6 We report a rare case of unilateral foveal neovascularisation (NVF) in a middle-aged (40 years) woman of Asian origin who presented to us with chief complaints of blurring of vision in both eyes (left more than right) over the past few weeks, which was sudden in onset and progressive in nature. The patient had type 2 diabetes mellitus and dyslipidaemia for the past nine years. Her HbA1c was 10.5 per cent. On examination, her best-corrected visual acuity was 6/12 in the right eye and 6/24 in the left eye. The anterior segment was within normal limits for her age. Meticulous examination of the iris did not reveal any sign of neovascularisation. Posterior segment examination revealed proliferative diabetic retinopathy changes in both eyes with vitreous haemorrhage in the left eye only. The right eye was noted to have a whitish tuft at the fovea on biomicroscopy which turned out to be vascular in nature with distorted foveal avascular zone (FAZ) in both multicolor (Figure 1) and re?ectance (Figure 2) image. This was con?rmed with fundus ?uorescein angiography (confocal scanning laser ophthalmoscope-based; Figure 3) and spectral domain optical coherence tomography (Figure 4). Unlike previous reports, except for the recent report by Seth et al.,6 this patient had non-insulin-dependent diabetes mellitus. It is possible that this type of diabetes mellitus is not a predictor of NVF, but rather compromised ocular blood ?ow and duration and control of diabetes are predictors as reported by Summanen et al.7 In concordance with Finkelstein et al.,2 Joondeph et al.3 and Seth et al.,6 we noted macular ischaemia in our case, whereas Kurz et al.4 and Rajagopal et al.5 reported cases with perfused macula. Our case had unilateral NVF as reported by Joondeph et al.,3 Kurz et al.4 and Seth et al.,6 whereas Finkelstein et al.2 and Kurz et al.4 reported bilateral cases. We report for the ?rst time multimodal imaging of foveal neovascularisation in diabetic retinopathy. Limitations include a lack of early-phase fundus ?uorescein angiography imaging, green re?ectance, and optical coherence tomography angiography images. The early phase of ?uorescein angiography would have helped us with more effective visualisation of distorted FAZ and leakage from the NVF. Green re?ectance utilises a longer wavelength as compared to blue and has less absorption by the crystalline lens and xanthophyll pigments (at fovea) and therefore better delineates the fovea. In our case, this would have been the better imaging modality than blue re?ectance. Optical coherence tomography angiography beyond being non-invasive would have helped us to portray the FAZ and origin of foveal neovascularisation in a more desirable way, which we lacked.