Screening examination in the office of the GP or the diabetologist where the patient already goes regularly.
Timing of first dilated ophthalmologic examination: First examination Age of onset of diabetes By 5 years after onset Not before puberty 0-30 yrs Once diagnosedOver 30 yrs During first trimesterWhile pregnant Following AAO preferred practice pattern
Recommended follow up schedule: Follow upFindings on first examination Annual None to minimal retinopathy 6-12 m Mild-to-moderate NPDR / no macular edema 4-6 m Mild-to-moderate NPDR / early macular edema 3-4 m Mod-to-severe NPDR Each trimester During pregnancy Consider treatment Very severe NPDR or early PDR Recommend treatment High-risk PDR or CSME Following AAO preferred practice pattern
A fully dilated examination * Sensitivity decreases by 50% if the eyes are undilated. Photography through dilated or (undilated) pupils * Easy – Acceptable – Mobile teams * Offers twice the utilization as a usual referral based system of care. Method of examination:
United Kingdom Prospective Diabetes Study (UKDPS) After 7.5 years, the group with tight control of hypertension (<105/85 mmHg) showed a 34% reduction in the risk of progression of retinopathy compared to the less tight control group (<180/105 mmHg).
Yes it is possible to greatly reduce the incidence of blindness from diabetic retinopathy through: 1.Early detection of DR 2.A tighter control of diabetes 3.A tight control of associated hypertension 4.Patient education and compliance