OBJECTIVE To evaluate retinal sensitivity over hard exudates in correlation with the spectral domain optical coherence tomography (SD-OCT) findings in eyes with diabetic retinopathy. METHODS Twelve eyes of 10 patients with hard exudates associated with diabetic retinopathy were enrolled in this study. All subjects underwent a complete ophthalmic examination including SD-OCT (Copernicus, Zawiercie, Poland) and microperimetry (MP1; Nidek Technologies, Padova, Italy). Retinal sensitivity was measured, over the areas with hard exudates and compared to corresponding locations devoid of hard exudates, using a semi-automatic program. The size of the hard exudate plaque was measured using the measurement software in the microperimeter. Retinal thickness in the area of the hard exudates and foveal thickness were measured using SD-OCT. RESULTS Mean retinal sensitivity over hard exudates was 4.97 ± 4.17 dB which was significantly (P = 0.0001) reduced as compared to locations devoid of hard exudates. No significant correlation (r=-0.23, P = 0.45) was found between the size of the hard exudates and retinal sensitivity. A significant negative correlation was found between retinal sensitivity and retinal thickness at the area of the hard exudates (r=-0.65, P = 0.05), and between retinal sensitivity and foveal thickness (r=-0.91, P = 0.001). CONCLUSIONS In eyes with diabetic retinopathy, retinal sensitivity was reduced due to the presence of hard exudates in the outer retinal layers and retinal thickening but this was not correlated with the size of the hard exudates.