A 17-year-old Caucasian male presented with a visual acuity of 20/400 in his right eye and reported a progressive visual decline over the previous two years. Anterior segment examination was normal. Dilated ophthalmoscopy disclosed superotemporal microaneurysms, sclerosed vessels, telangiectasis and extensive retinal lipid exudation involving the fovea. OCT measured the foveal thickness at 238 µm, increasing to 330 µm superior to the fovea. On fluorescein angiography, leaking microaneurysms, telangiectasis and capillary dropout were noted in the same area. The left eye was unremarkable. Grid pattern laser treatment was performed.