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Retinopathy, Diabetic

Richard W. Allinson, MD and Francis Allinson, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Noninflammatory retinal disorder characterized by retinal capillary closure and microaneurysms. Retinal ischemia leads to release of a vasoproliferative factor, stimulating neovascul...

DIAGNOSIS

PHYSICAL EXAM

  • Eye exam: measurement of visual acuity and documentation of the status of the iris, lens, vitreous, and fundus

  • Nonproliferative (background) DR

    • Microaneurysms

    • Intraretinal hemorrha...

TREATMENT

GENERAL MEASURES

  • The Diabetes Control and Complications Trial (DCCT) recommended that for most patients with insulin-dependent DM, blood glucose levels should be as close to the nondiabetic r...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Scheduled ophthalmologic eye exams 
  • Yearly follow-up if no retinopathy

  • Every 6 months with background DR

  • At least every 3 to 4 months with pre-PDR

  • E...

REFERENCES

1
Vail D, Callaway NF, Ludwig CA, et al. Lipid-lowering mediations are associated with lower risk of retinopathy and ophthalmic interventions among U.S. patients with diabetes. Am J Ophthalm...

ADDITIONAL READING

  • Fassbender JM, Ozkok A, Canter H, et al. A comparison of immediate and delayed vitrectomy for the management of vitreous hemorrhage due to proliferative diabetic retinopathy. Ophtha...

CODES

ICD10

  • E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema

  • E10.319 Type 1 diabetes mellitus with unspecified diabetic retinopathy without macular edema

  • E10.3...

CLINICAL PEARLS

  • Schedule yearly ophthalmologic eye exams.

  • Options for the treatment of diabetic macular edema include focal laser treatment, intravitreal triamcinolone, intravitreal ranibizumab, intrav...

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