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You see a 60 year old lady for her medication review. Past medical history incudes Diabetes, Hypertension and Osteoarthritis. She admits she has not attended her last diabetic eye screen as she forgot the appointment and did not reschedule it given that she has no concerns regarding her vision. You offer to carry out fundoscopy and note the presence of pale-yellow spots on the retina.

What is the most likely diagnosis?

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