Diabetic Retinopathy Recommendations

	2016 ADA Guideline Recommendations
Types of Diabetes Mellitus
Main Diabetes Page
Diabetes type I
Diabetes type II
Gestational Diabetes Mellitus
2016 ADA Standard of Medical Care Guideline Recommendations
Strategies for Improving Care
Classification and Diagnosis of Diabetes
Foundations of Care and Comprehensive Medical Evaluation Diabetes Self-Management, Education, and Support Nutritional Therapy
Prevention or Delay of Type II Diabetes
Glycemic Targets
Obesity Management for Treatment of Type II Diabetes
Approaches to Glycemic Treatment
Cardiovascular Disease and Risk Management Hypertension and Blood Pressure Control Lipid Management Antiplatelet Agents Coronary Heart Disease
Microvascular Complications and Foot Care Diabetic Kidney Disease Diabetic Retinopathy Diabetic Neuropathy Diabetic Footcare
Older Adults with Diabetes
Children and Adolescents with Diabetes Management of Cardiovascular Risk Factors in Children and Adolescents with Diabetes Microvascular Complications in Children and Adolescents with Diabetes
Management of Diabetes in Pregnancy
Diabetes Care in the Hospital Setting

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shivani Chaparala M.B.B.S [2]; Tarek Nafee, M.D. [3]

2016 ADA Standards of Medical Care in Diabetes Guidelines^[1][edit | edit source]

"1. Optimize glycemic control to reduce the risk or slow the progression of diabetic retinopathy. (Level of Evidence: A)"
"2. Optimize blood pressure and serum lipid control to reduce the risk or slow the progression of diabetic retinopathy. (Level of Evidence: A)"

"1. Adults with type 1 diabetes should have an initial dilated and compre- hensive eye examination by an oph- thalmologist or optometrist within 5 years after the onset of diabetes. '(Level of Evidence: B)"
"2. Patients with type 2 diabetes should have an initial dilated and compre- hensive eye examination by an oph- thalmologist or optometrist at the time of the diabetes diagnosis. (Level of Evidence: B)"
"3. If there is no evidence of retinop- athy for one or more annual eye exams, then exams every 2 years may be considered. If any level of diabetic retinopathy is present, subsequent dilated retinal exami- nations for patients with type 1 or type 2 diabetes should be re- peated at least annually by an ophthalmologist or optometrist. If retinopathy is progressing or sight-threatening, then examinations will be required more frequently. (Level of Evidence: B)"
"4. While retinal photography may serve as a screening tool for reti- nopathy, it is not a substitute for a comprehensive eye exam, which should be performed at least ini- tially and at intervals thereafter as recommended by an eye care professional. (Level of Evidence: E)"
"5. Eye examinations should occur be- fore pregnancy or in the first tri- mester, and then patients should be monitored every trimester and for 1 year postpartum as indicated by the degree of retinopathy. (Level of Evidence: B)"

"1. Promptly refer patients with any level of macular edema, severe nonproliferative diabetic retinopathy (a precursor of proliferative diabetic retinopathy), or any pro- liferative diabetic retinopathy to an ophthalmologist who is knowledgeable and experienced in the management and treatment of diabetic retinopathy. (Level of Evidence: A)"
"2. Laser photocoagulation therapy is indicated to reduce the risk of vision loss in patients with high-risk proliferative diabetic retinopathy and, in some cases, severe nonproliferative diabetic retinopathy (Level of Evidence: A)"
"3. Intravitreal injections of antivas- cular endothelial growth factor are indicated for center-involved diabetic macular edema, which occurs beneath the foveal center and may threaten reading vision (Level of Evidence: A)"
"4. The presence of retinopathy is not a contraindication to aspirin therapy for cardioprotection, as aspirin does not increase the risk of retinal hemorrhage (Level of Evidence: A)"