What is the follow-up care in the treatment of diabetic retinopathy?

Updated: Sep 02, 2021
  • Author: Abdhish R Bhavsar, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

The frequency of follow-up care is dictated primarily by the baseline stage of the retinopathy and its rate of progression to proliferative diabetic retinopathy (PDR). Only 5% of patients with mild nonproliferative diabetic retinopathy (NPDR) would progress to PDR in 1 year without follow-up care, and thus, monitoring these patients every 6-12 months is appropriate. As many as 27% of patients with moderate NPDR would progress to PDR in 1 year; therefore, they should be seen every 4 to 8 months.

More than 50% of patients with severe NPDR (preproliferative stage) would progress to PDR in a year without follow-up care and 75% would develop high-risk characteristics within 5 years; thus, follow-up care as frequently as every 2 to 3 months is mandated to ensure prompt recognition and treatment.

Any stage associated with clinically significant macular edema should be treated promptly with laser panretinal photocoagulation and observed closely (every 1-2 mo) to monitor the status of the macula and decrease the chance of severe visual loss.

Diabetes mellitus, in general, and diabetic retinopathy, in particular, are progressive conditions, and regular follow-up care with a physician is crucial for detection of any changes that may benefit from treatment.


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