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Diabetic Retinopathy

See Also
1. Diabetes Complications
Epidemiology
1. Occurs in 20% of patients with Diabetes Mellitus
2. Occurs equally in Type I and Type II Diabetes Mellitus
Risk Factors
1. Longer duration of Diabetes Mellitus (>72 months)
2. Poor Blood Glucose control (Hgb A1C > 8.0)
3. Increased microalbuminuria levels (>9.5)
4. Saum (2002) Br J Gen Pract 52:214
Types
1. Nonproliferative Retinopathy
  1. Retinal veins dilated
  2. Cotton Wool exudates or spots
  3. Hard exudates
  4. Macular edema
  5. Intraretinal hemorrhages
  6. Microaneurysms
2. Proliferative Retinopathy
  1. Neovascularization
  2. Preretinal hemorrhages
  3. Vitreous Hemorrhages
  4. Vascular fibrosis
Protocol: Ophthalmology Exam Intervals with no retinal disease
1. Children with Diabetes
  1. Initial Exam: Age 10 years (or after 3-5 years of Diabetes Mellitus)
  2. Subsequent Exams: Annually
2. Adults with Type 2 Diabetes
  1. Initial Exam: At diagnosis
  2. Subsequent Exams: Annually
Protocol: Ophthalmology Exam Intervals for those with retinal disease
1. Mild to moderate nonproliferative diabetic retinopathy
  1. No macular edema: Exams every 6-12 months
  2. Macular edema present: Consider laser photocoagulation
2. Severe nonproliferative diabetic retinopathy
  1. Eye examinations every 2-4 months
  2. Consider laser photocoagulation
3. Proliferative diabetic retinopathy
  1. Consider laser photocoagulation
Resources
1. AAO Practice Guideline
  1. http://www.aao.org/education/guidelines/ppp/dr_new.cfm

Diabetic Retinopathy (C0011884)
Definition (MSH)	Disease of the RETINA as a complication of DIABETES MELLITUS. It is characterized by the progressive microvascular complications, such as ANEURYSM, interretinal EDEMA, and intraocular PATHOLOGIC NEOVASCULARIZATION.
Definition (CSP)	retinal changes occurring in diabetes mellitus, marked by microaneurysms, exudates, and hemorrhages, and sometimes by neovascularization.
Concepts	Disease or Syndrome (T047)
ICD9	362.0, 362.01
MSH	D003930
English	Diabetic Retinopathies, Diabetic Retinopathy, DR, DR - Diabetic retinopathy, Retinal abnormality - diabetes-related, Retinopathy - diabetic
Spanish	anomalia retiniana relacionada con diabetes, retinopatia diabetica
Parent Concepts	Retinal Diseases (C0035309), DIABETIC OPHTHALMOPATHY (C0920358), Other retinal disorder NOS (C0339438), Diabetic Angiopathies (C0011875), Retinal vascular disorder (C0154833), Diabetic Retinopathy (C0011884), Degenerative disorder of eye (C0154777), Diabetes mellitus NOS with ophthalmic manifestation (C0342245), Duplicate concept (C1274013)
Sources	COSTAR, CSP, DXP, ICD9CM, LCH, LNC, MSH, MTH, MTHICD9, NCI, NDFRT, QMR, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System)