Last reviewed: 13 Feb 2025
Last updated: 05 Nov 2024
Summary
Definition
History and exam
Key diagnostic factors
- diabetes
Full details
Other diagnostic factors
- microaneurismas
- exudados algodonosos
- hemorragia intrarretiniana
- exudados lipídicos
- edema macular
- rosario venoso
- anomalías microvasculares intrarretinianas
- neovascularización de la papila óptica
- neovascularización de la retina
- hemorragia prerretiniana o vítrea
- desprendimiento de retina
Full details
Risk factors
- diabetes de duración más prolongada
- control glucémico deficiente
- niveles elevados de lípidos
- hipertensión
- nefropatía
- grupo étnico
- embarazo
- cirugía de cataratas
Full details
Diagnostic tests
1st tests to order
- tomografía de coherencia óptica
- fotografía de fondo de ojo/fotografía de fondo de ojo de gran campo
Full details
Tests to consider
- angiografía fluoresceínica/angiografía fluoresceínica de campo amplio
- angiografía por tomografía de coherencia óptica
- Ecografía B-scan
Full details
Treatment algorithm
ACUTE
retinopatía diabética no proliferativa
retinopatía diabética proliferativa
Neovascularización del iris
Retinopatía diabética proliferativa avanzada
ONGOING
edema macular que no responde al tratamiento intravítreo con anti-VEGF
edema macular con tracción vitreomacular anteroposterior
edema macular crónico, isquemia macular, desprendimiento macular crónico, atrofia óptica secundaria a glaucoma neovascular
Contributors
Authors
Jonathan Dowler, MD, FRCS, FRCOphth

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 topic.
Disclosures
RH declares that he has no competing interests.
Peer reviewers
Adrienne W Scott, MD
Chief
Wilmer Eye Institute
Bel Air
Associate Professor of Ophthalmology
Johns Hopkins University School of Medicine
Baltimore
MD
Disclosures
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.
Differentials
- Síndrome isquémico ocular
- Retinopatía por radiación
- Oclusión venosa retiniana
More DifferentialsGuidelines
- Standards of care in diabetes
- Vision rehabilitation: preferred practice pattern
More GuidelinesPatient information
Diabetes type 2: should I take insulin?
Diabetes type 2: what treatments work?
More Patient informationLog in or subscribe to access all of BMJ Best Practice
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