Monitoring
Review intervals for nonproliferative diabetic retinopathy (NPDR) and PDR have been suggested by the American Academy of Ophthalmology as follows:[62][87]
Normal or mild NPDR: 12 months
Mild/moderate NPDR without clinically significant macular edema: 3 to 12 months
Mild/moderate NPDR with clinically significant macular edema: 1 month
Severe NPDR without clinically significant macular edema: 2 to 4 months
Severe NPDR with clinically significant macular edema: 1 month
Non-high-risk PDR without clinically significant macular edema: 2 to 4 months
Non-high-risk PDR with clinically significant macular edema: 1 month
High-risk PDR without clinically significant macular edema: 2 to 4 months
High-risk PDR with clinically significant macular edema: 1 month
Review intervals for patients undergoing intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection for macular edema 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 primary care physician/diabetologist to ensure good glycemic and hypertensive control and treatment of dyslipidemia 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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