In 1855, Eduard Jaeger, an Austrian physician, was the first to painstakingly portray the retinal findings associated with diabetes in his seminal work "Beitrage zur Pathologie des Auges" (1). With a newly developed direct ophthalmoscope, he produced one of the first atlases containing 21 color plates of fundus paintings and described a "roundish" or oval yellowish spots and full or partial thickness extravasations through the retina in the macular region of a diabetic patient (1). Jaeger findings of the association between diabetes and retinal changes were controversial and were not adopted by the medical community. The debate as to whether macular changes were directly related to diabetes or whether they were caused by atherosclerosis and hypertension was unresolved at the beginning of the 20th century, until Arthur James Ballantyne, suggested that diabetic retinopathy represents a unique form of vasculopathy and his work showed for the first time the role of capillary wall alterations in the development of diabetic retinopathy as well as the presence of deep waxy exudates in the outer plexiform layer (2).
