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You see a 74 year old lady with severe Dementia with her husband for her medication review. Past medical history includes Hypertension, Osteoporosis, Diabetes and COPD. She is an ex-smoker and you note she has had a previous cataract operation. Her husband is concerned that she has frequent falls and asks you to examine her eyes as it is difficult to arrange her to see the optician.

You offer to carry out fundoscopy and note the presence of cotton wool spots and ‘dot and blot’ haemorrhages.

What is the most likely diagnosis?

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