The exudative lesions in diabetic retinopathy have received less attention than the more dramatic changes in the capillaries and veins which make up the characteristic fundus picture. Apart from the occasional fleck found in early cases of diabetic retinopathy the exudates appear in three main forms: a cluster of small deposits, a ring, and a large waxy-looking plaque.Serial fundus photographs taken at frequent intervals for 2 to 4 years have confirmed the observations of Whittington (1951), Larsen (1960), and other workers, that diabetic exudates disappear spontaneously. There are, however, differences in the evolution and devolution of the three types.(a) Cluster Form.-This is a collection of small white exudates giving a speckled appearance to a localized area of retina usually a half to one disc diameter in extent. It is often repeated in several parts of the posterior pole and is not generally associated with the normal vessels, aneurysms, or haemorrhages. This cluster form is the most transient type of exudative lesion, and we have observed it to appear and disappear in as short a period as 4 months.

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The retinal and neurological complications of abetalipoproteinaemia may be preventable by replacing vitamins A and E from an early age, but their role in adult presentations is less clear. Two adult females with abetalipoproteinaemia have received 8 and 10 years respectively of replacement therapy with vitamins A, E and linoleic acid. In Case 1, visual function improved objectively on commencing therapy but has subsequently deteriorated and her neuropathy has slowly progressed. The rate of progression of neurological impairment in Case 2 was slowed but not halted by therapy, and her severe visual disturbance was unaffected. Replacement by fat soluble vitamins has only a limited role in the management of abetalipoproteinaemia once irreversible neurological/retinal damage has occurred.