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Retinopatia diabética

Evidence last reviewed: 11 Jun 2026
Topic last updated: 05 Jun 2026

Summary

Definition

History and exam

Key diagnostic factors

  • diabetes
Full details

Other diagnostic factors

  • microaneurismas
  • manchas brancas do tipo "bolas de algodão"
  • hemorragia intrarretiniana
  • exsudatos lipídicos
  • edema macular
  • beading venoso
  • anormalidades microvasculares intrarretinianas
  • neovascularização do disco óptico
  • neovascularização retiniana
  • hemorragia pré-retiniana ou vítrea
  • descolamento de retina
Full details

Risk factors

  • diabetes de duração prolongada
  • controle glicêmico inadequado
  • dislipidemia
  • hipertensão
  • doença renal
  • etnia
  • gestação
  • cirurgia de catarata
  • melhora rápida no controle glicêmico
Full details

Diagnostic investigations

1st investigations to order

  • tomografia de coerência óptica
  • fotografia de fundo do olho/fotografia de fundo do olho de campo amplo
Full details

Investigations to consider

  • angiografia fluoresceínica/angiografia fluoresceínica de campo amplo
  • angiotomografia de coerência óptica
  • ultrassonografia modo B
  • gonioscopia
Full details

Emerging tests

  • eletrorretinografia
  • testes de campo visual e perimetria cromática adaptada ao escuro
  • análise de imagens de angiografia por tomografia de coerência óptica assistida por inteligência artificial (IA)

Treatment algorithm

ACUTE

retinopatia diabética não proliferativa (RDNP): leve

retinopatia diabética não proliferativa (RDNP): moderada

retinopatia diabética não proliferativa (RDNP): grave

retinopatia diabética proliferativa (RDP): de não alto risco

retinopatia diabética proliferativa (RDP): alto risco

retinopatia diabética proliferativa (RDP): avançada

neovascularização da íris

ONGOING

edema macular diabético sem resposta clínica a injeções intravítreas de inibidor do fator de crescimento endotelial vascular (VEGF)

edema macular com tração vítreo-macular anteroposterior

edema macular crônico, isquemia macular, descolamento macular crônico, atrofia óptica secundária a glaucoma neovascular

Contributors

Authors

Corrina P. Azarcon, MD

Assistant Professor/Clinical

Department of Ophthalmology

The University of Texas at San Antonio Health Science Center

San Antonio, TX

Disclosures

CA declares that she is a faculty member (Retina Specialist) of the University of Texas at San Antonio Health Science Center.

Acknowledgements

Dr Corrina P. Azarcon would like to gratefully acknowledge Dr Johnathan Dowler and Dr Robin Hamilton, previous contributors 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.

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Academy of Ophthalmology. Diabetic retinopathy PPP 2024. Feb 2025 [internet publication].Full text

American Diabetes Association. Standards of care in diabetes - 2025. Diabetes Care 2025 Jan 1;48(suppl 1):S1-343.Full text

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.Full text  Abstract

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.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Retinopatia diabética images
  • Differentials

    • Síndrome isquêmica ocular
    • Retinopatia por radiação
    • Oclusão venosa retiniana
    More Differentials
  • Guidelines

    • Type 2 diabetes in adults: management
    • Retina summary benchmarks - 2025
    More Guidelines
  • Patient information

    Diabetes: o que posso fazer para me manter saudável?

    Diabetes: o que é?

    More Patient information
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