Diabetic retinopathy

Last reviewed: 2 Sep 2022
Last updated: 16 Mar 2022

Summary

Definition

History and exam

Key diagnostic factors

  • diabetes
More key diagnostic factors

Other diagnostic factors

  • microaneurysms
  • cotton wool spots
  • intraretinal haemorrhage
  • lipid exudates
  • floaters
  • macular thickening
  • vision loss
  • venous beading
  • intraretinal microvascular abnormalities
  • optic disc neovascularisation
  • retinal neovascularisation
  • pre-retinal or vitreous haemorrhage
  • retinal detachment
Other diagnostic factors

Risk factors

  • young-onset diabetes
  • longer duration of diabetes
  • poor glycaemic control
  • hypertension
  • renal disease
  • Pima Indians
  • pregnancy
  • cataract surgery
  • elevated lipid levels
More risk factors

Diagnostic investigations

1st investigations to order

  • photographs of the fundus
  • optical coherence tomography scanning
  • fluorescein angiography
  • B scan ultrasonography
More 1st investigations to order

Treatment algorithm

ACUTE

NPDR: non-severe

NPDR:severe/PDR: non-high-risk

PDR: high-risk/iris neovascularisation

PDR: severe

ONGOING

refractory disease

Contributors

Authors

Jonathan Dowler, MD, FRCS, FRCOphth
Jonathan Dowler

Consultant Ophthalmic Surgeon

The London Clinic

London

UK

Disclosures

JD declares that he has no competing interests.

Acknowledgements

Dr Jonathan Dowler would like to gratefully acknowledge Dr Robin Hamilton, a previous contributor to this monograph. RH declares that he has no competing interests.

Peer reviewers

Zachary Bloomgarden, MD

Clinical Professor

Medicine/Endocrinology

Diabetes and Bone Disease

Mount Sinai School of Medicine

New York

NY

Disclosures

ZB declares that he has no competing interests.

Tien Y. Wong, MD, MPH, PhD

Head of Department of Ophthalmology

University of Melbourne

Victoria

Australia

Disclosures

TYW declares that he has no competing interests.

Stephen Schwartz, MD

Medical Director

Bascom Palmer Eye Institute

Miami

FL

Disclosures

Within the last 5 years, SS has received funding for organizing continuing medical education conferences from Alcon, Genentech, and Novartis; has owned shares in Pfizer; has received research funding from Genentech; and is co-holder of a patent pending on "Molecular targets for modulating intraocular pressure and differentiation of steroid responders versus nonresponders.

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  • Guidelines

    • Type 2 diabetes in adults: management
    • Standards of medical care in diabetes - 2022
    More Guidelines
  • Patient leaflets

    Diabetes type 2: should I take insulin?

    Diabetes type 2: what treatments work?

    More Patient leaflets
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