Retinopatia diabética
Summary
Definition
History and exam
Key diagnostic factors
- diabetes
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
Risk factors
- diabetes de duração prolongada
- controle glicêmico inadequado
- níveis lipídicos elevados
- hipertensão
- doença renal
- etnia
- gestação
- cirurgia de catarata
Diagnostic tests
1st tests to order
- tomografia de coerência óptica
- fotografia de fundo do olho/fotografia de fundo do olho de campo amplo
Tests to consider
- angiografia fluoresceínica/angiografia fluoresceínica de campo amplo
- angiotomografia de coerência óptica
- ultrassonografia modo B
Treatment algorithm
retinopatia diabética não proliferativa
petinopatia diabética proliferativa
neovascularização da íris
retinopatia diabética proliferativa avançada
edema macular sem resposta clínica à terapia com anti-VEGF intravítreo
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
Key articles
American Academy of Ophthalmology. Preferred practice pattern: diabetic retinopathy. Oct 2019 [internet publication].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
American Academy of Ophthalmology. Preferred practice patterns: retina summary benchmarks. Dec 2024 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Síndrome isquêmica ocular
- Retinopatia por radiação
- Oclusão venosa retiniana
More DifferentialsGuidelines
- Standards of care in diabetes
- Retina summary benchmarks
More GuidelinesPatient information
Diabetes do tipo 2: quais tratamentos funcionam?
Diabetes: o que posso fazer para me manter saudável?
More Patient information
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