Monitoring

Review intervals for non-proliferative diabetic retinopathy (NPDR) and PDR have been suggested by the American Academy of Ophthalmology as follows:[62][117]

  • Normal or mild NPDR: 12 months

  • Mild/moderate NPDR without clinically significant macular oedema: 3 to 12 months

  • Mild/moderate NPDR with clinically significant macular oedema: 1 month

  • Severe NPDR without clinically significant macular oedema: 2 to 4 months

  • Severe NPDR with clinically significant macular oedema: 1 month

  • Non-high-risk PDR without clinically significant macular oedema: 2 to 4 months

  • Non-high-risk PDR with clinically significant macular oedema: 1 month

  • High-risk PDR without clinically significant macular oedema: 2 to 4 months

  • High-risk PDR with clinically significant macular oedema: 1 month

Review intervals for patients undergoing intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection for macular oedema will depend on the regimen employed: monthly in patients undergoing as-needed treatment, and adjusted according to the optical coherence tomography appearances for those in a treat-and-extend regimen.

Pregnancy

Retinopathy can progress rapidly during pregnancy, and patients should be monitored early and closely, according to the severity of retinopathy.

Systemic monitoring

Regular review by a general practitioner/diabetologist to ensure good glycaemic and hypertensive control and treatment of dyslipidaemia will delay the onset and slow the progression of diabetic retinopathy.

Education

Periodic continuing patient education regarding the importance of these parameters on retinopathy should be undertaken.

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