Retinopathy, Diabetic
Basics
Description
- Most patients with diabetes mellitus (DM) will develop diabetic retinopathy (DR). It is the leading cause of new cases of legal blindness among residents in the United States between the ages of 20 and 64 years.
- DR can be divided into three stages:
- Nonproliferative diabetic retinopathy (NPDR) (background)
- Severe NPDR (preproliferative)
- Proliferative diabetic retinopathy [PDR]
Pregnancy Considerations
Pregnancy can exacerbate condition.
Epidemiology
Incidence
- Peak incidence of type 1, juvenile-onset DM is between the ages of 12 and 15 years.
- Peak incidence of type 2, adult-onset DM is between the ages of 50 and 70 years.
Prevalence
- Worldwide, DR affects 1 out of 3 persons with DM.
- 2/3 of type 1 DM (T1DM) patients who have had DM for at least 35 years will develop PDR, and 1/3 will develop diabetic macular edema (DME). Proportions are reversed for type 2 DM (T2DM).
Etiology and Pathophysiology
- Related to development of diabetic microaneurysms and microvascular abnormalities
- Vascular endothelial growth factor (VEGF) is elevated in patients with hypoxic retina. Intraocular levels of VEGF are elevated in patients with retinal or iris NV. Retinal hypoxia also contributes to DME, and VEGF is a major contributor to DME.
Risk Factors
- Renal disease
- Systemic hypertension (HTN)
- Smoking
- Elevated lipid levels
General Prevention
- Monitor and control of blood glucose.
- Schedule yearly ophthalmologic eye exams.
Commonly Associated Conditions
- Glaucoma; cataracts
- Retinal detachment; vitreous hemorrhage (VH)
- Disc edema (diabetic papillopathy)
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Citation
Domino, Frank J., et al., editors. "Retinopathy, Diabetic." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116528/all/Retinopathy__Diabetic.
Retinopathy, Diabetic. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116528/all/Retinopathy__Diabetic. Accessed November 11, 2024.
Retinopathy, Diabetic. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116528/all/Retinopathy__Diabetic
Retinopathy, Diabetic [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 November 11]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116528/all/Retinopathy__Diabetic.
* Article titles in AMA citation format should be in sentence-case
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T1 - Retinopathy, Diabetic
ID - 116528
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
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PB - Wolters Kluwer
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DB - Medicine Central
DP - Unbound Medicine
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