Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- diabetes
Outros fatores diagnósticos
- microaneurysms
- cotton wool spots
- intraretinal hemorrhage
- lipid exudates
- macular edema
- venous beading
- intraretinal microvascular abnormalities
- optic disk neovascularization
- retinal neovascularization
- preretinal or vitreous hemorrhage
- retinal detachment
Fatores de risco
- longer duration of diabetes
- poor glycemic control
- elevated lipid levels
- hypertension
- renal disease
- ethnicity
- pregnancy
- cataract surgery
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- optical coherence tomography
- fundus photography/wide-field fundus photography
Investigações a serem consideradas
- fluorescein angiography/wide-field fluorescein angiography
- optical coherence tomography angiography
- B-scan ultrasonography
Algoritmo de tratamento
nonproliferative diabetic retinopathy
proliferative diabetic retinopathy
iris neovascularization
advanced proliferative diabetic retinopathy
macular edema unresponsive to intravitreal anti-VEGF therapy
macular edema with anteroposterior vitreomacular traction
chronic macular edema, macular ischemia, chronic macular detachment, optic atrophy secondary to neovascular glaucoma
Colaboradores
Autores
Jonathan Dowler, MD, FRCS, FRCOphth
Consultant Ophthalmic Surgeon
The London Clinic
London
UK
Declarações
JD declares that he has no competing interests.
Agradecimentos
Dr Jonathan Dowler would like to gratefully acknowledge Dr Robin Hamilton, a previous contributor to this topic.
Declarações
RH declares that he has no competing interests.
Revisores
Adrienne W Scott, MD
Chief
Wilmer Eye Institute
Bel Air
Associate Professor of Ophthalmology
Johns Hopkins University School of Medicine
Baltimore
MD
Declarações
AWS has received grant support and consulting honoraria from Genentech/Roche. She has also received consulting honoraria from Allergan/AbbVie Inc., Novartis, Regeneron, Bausch and Lomb, and Alimera Sciences.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
American Academy of Ophthalmology. Preferred practice pattern: diabetic retinopathy. Oct 2019 [internet publication].Texto completo
Wong TY, Sun J, Kawasaki R, et al. Guidelines on diabetic eye care: The International Council of Ophthalmology recommendations for screening, follow-up, referral, and treatment based on resource settings. Ophthalmology. 2018 Oct;125(10):1608-22.Texto completo Resumo
Solomon SD, Chew E, Duh EJ, et al. Diabetic retinopathy: a position statement by the American Diabetes Association. Diabetes Care. 2017 Mar;40(3):412-8.Texto completo Resumo
American Diabetes Association. Standards of care in diabetes - 2024. Diabetes Care. 2024 Jan;47(suppl 1):S1-321.Texto completo
American Academy of Ophthalmology. Preferred practice patterns: retina summary benchmarks. Dec 2023 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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