Diabetic retinopathy
Also known as: diabetic eye disease · macular edema
Free to read — no account needed. Sign in only to bookmark this disease and track your study progress.
Diabetic Retinopathy Preferred Practice Pattern (PPP) 2024
American Academy of Ophthalmology (AAO) · 2024
The AAO's Preferred Practice Pattern for diabetic retinopathy, developed by its Retina/Vitreous Committee. It sets out when screening eye examinations should begin and how often they should be repeated for type 1 and type 2 diabetes, the role of dilated examination versus validated digital imaging, and management of vision-threatening disease. Published online in the journal Ophthalmology.
- Addresses when to begin and how often to repeat retinopathy screening in type 1 versus type 2 diabetes. source
- Developed by the AAO Preferred Practice Pattern Retina/Vitreous Committee and published online in Ophthalmology. source
- Full text also available through the Ophthalmology journal Preferred Practice Pattern collection. source
ICO Guidelines for Diabetic Eye Care
International Council of Ophthalmology (ICO) · 2017 · 2017 update
The International Council of Ophthalmology's guidance on diabetic eye care, written to be applied across different resource settings. It covers screening people with diabetes for sight-threatening retinopathy, referral and follow-up intervals, and management of diabetic macular oedema and proliferative disease, including laser, anti-VEGF and corticosteroid options, plus situations such as pregnancy and concurrent cataract.
- Written with separate recommendations for high-resource and low- or intermediate-resource settings. source
- Covers screening, referral criteria, follow-up intervals, and treatment of diabetic macular oedema and proliferative retinopathy. source
- The 2017 edition remains the current version listed by the ICO. source
US vs EU key differences
- The international guideline is explicitly resource-stratified: the ICO recommends different follow-up intervals depending on setting, for example 1-2 years for mild retinopathy in low- and middle-income countries versus 6-12 months in high-income countries, whereas the AAO Preferred Practice Pattern gives a single set of intervals for a high-resource system. source
- Screening entry points converge: both the AAO and the ICO start screening at the time of diagnosis for type 2 diabetes and around puberty (or after roughly five years of disease) for type 1 diabetes. source
- Version currency differs by seven years: the US Preferred Practice Pattern was updated in 2024, while the ICO Guidelines for Diabetic Eye Care date to 2017, when their headline updates were the incorporation of optical coherence tomography and anti-VEGF therapy. source
What changed recently
- US2019 → 20242024-01-01
The 2024 revision of the 2019 Diabetic Retinopathy PPP folds in the evidence accumulated since 2019 on intravitreal anti-VEGF therapy for centre-involving diabetic macular oedema and for reducing retinopathy severity in proliferative disease, adds a caution that rapid tightening of glycaemic control with newer agents such as semaglutide can precipitate early worsening of retinopathy, and reinforces topical povidone-iodine antisepsis before every intravitreal injection.
source ↗curation confidence 80% - GLOBAL2014 → 2017 update2017-01-01
A new ICO task force reworked the 2014 diabetic eye care guidelines around resource setting, tiering screening, referral and follow-up schedules separately for high-resource versus low- and intermediate-resource countries, and adding guidance on optical coherence tomography for diabetic macular oedema plus intravitreal anti-VEGF therapy plus corticosteroids in selected cases alongside laser photocoagulation.
source ↗curation confidence 90%
See the full update feed for changes across every system.