Click image above to enlarge.Īn estimated 25.6 million Americans age 20 or older have diabetes, with a third still undiagnosed. Note the three dot hemorrhages superior to the macula. Below, this image shows a patient with mild nonproliferative diabetic retinopathy. 10 An Eidon True Color Confocal Scanner was used to image this PDR with an area of NVE at 10 o’clock. 10,11 For every 1% decrease in HbA1c, there was a corresponding 35% risk reduction in retinopathy. For example, the United Kingdom Prospective Diabetes Study revealed intensive blood sugar control in newly diagnosed patients with Type 2 diabetes had less microvascular complications, including retinopathy, compared with patients who received standard treatment.

Multiple clinical studies, as well as epidemiologic studies, support this association.

Proliferative diabetic retinopathy is found in approximately 2% of type 2 patients who have diabetes for less than five years, and 25% who have had diabetes for 25 years or more. After 10 years, the numbers increase to 84% and 53%, respectively. 7,8 In Type 2 patients older than age 30 with a known duration of diabetes of less than five years, 40% of patients taking insulin and 24% of those not taking insulin are found to have retinopathy. 7,8 These numbers increase to almost 60% after 10 years and greater than 80% after 15 years. Approximately 25% of Type 1 patients have some retinopathy after five years. Using an Eidon True Color Confocal Scanner, this image shows moderate to severe NPDR with multiple cotton-wool spot and dot/blot hemorrhages. Two particular aspects of diabetes can put patients at risk for developing diabetic retinopathy: duration and glycemic control. This article explains the care diabetes patients require and details the biological processes that indicate where to classify a patient with diabetic retinopathy, as well as what treatment should follow. It may seem like minutiae, but even minor distinctions can be valuable as they inform our treatment protocol and, ultimately, prevent significant visual impairment for our patients. These categories are each further split by severity. In the case of diabetic retinopathy, these are divided, chiefly, into two: proliferative diabetic retinopathy and nonproliferative diabetic retinopathy. With management of this disease now firmly in optometry’s wheelhouse, the depth of research into its ocular impact has provided the ability to delineate its progression using various categories. To day, optometrists play a crucial role in managing diabetes, a leading-and growing-instigator of vision loss.

Dot blot hemorrhage vs microaneurysm