Diabetic Retinopathy Preferred Practice Pattern®

Abstract

for Quality Eye Care without any external financial support. Authors and reviewers of the guidelines are volunteers and do not receive any financial compensation for their contributions to the documents. The guidelines are externally reviewed by experts and stakeholders before publication.

Nonmydriatic Photographic Screening for Diabetic Retinopathy in Pregnant Patients with Pre-Existing Diabetes in a Safety Net Population: 1 Year Results from the Diabetic Retinopathy in Pregnant Patients Study

“…Others are recommended for repeat photography at the time interval dictated by the AAO screening guidelines. 8 Recommendations for follow-up or referral are documented in the shared electronic medical record. Any patients requiring referral are scheduled in the ophthalmology clinic.…”

“…7 To reduce the risk of progressive DR and vision loss during pregnancy, the American Academy of Ophthalmology (AAO) and American Diabetes Association (ADA) recommend counseling for all diabetic patients seeking pregnancy on their increased risk of DR, and at least an examination during the first trimester. 8,9 Patients with no retinopathy or mild to moderate nonproliferative DR (NPDR) should receive additional follow-up every 3-12 months, and those with severe NPDR or proliferative DR (PDR) should receive follow-up every 1-3 months. 8 In states such as California, where low-income pregnant patients automatically qualify for insurance coverage through Medicaid, pregnancy offers a unique window for health interventions as these patients have significantly increased access to care and care utilization during their pregnancy.…”

“…8,9 Patients with no retinopathy or mild to moderate nonproliferative DR (NPDR) should receive additional follow-up every 3-12 months, and those with severe NPDR or proliferative DR (PDR) should receive follow-up every 1-3 months. 8 In states such as California, where low-income pregnant patients automatically qualify for insurance coverage through Medicaid, pregnancy offers a unique window for health interventions as these patients have significantly increased access to care and care utilization during their pregnancy. 10 Many women may receive their first hemoglobin A1c test and subsequent diagnosis of DM during their first prenatal visit, allowing for disease intervention both during and after their pregnancy.…”

A virtual-clinic pathway for patients referred from a national diabetes eye screening programme reduces service demands whilst maintaining quality of care

“…Eminence-based hospital guidance directs patients referred by the DESP with suspicion of severe retinal disease to a F2F clinic. The intention here is to minimise and prevent unnecessary delays between referral and potential vision-preserving treatment [ 20 , 21 ]. Yet, we did not observe a statistically significant difference in the mean duration from urgent referral to appointment in F2F and virtual clinics; despite all urgent referrals to virtual clinic being clerical errors.…”

<p>Patient Preferences Associated with Anti-Vascular Endothelial Growth Factor Therapies for Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema</p>

“…Diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD) are leading causes of blindness among working-age and elderly populations, respectively. Intravitreal anti-vascular endothelial growth factor (VEGF) therapy is considered the standard of care for nAMD and DME, 1,2 with four agents commonly used in current clinical practice: US Food and Drug Administration (FDA)-approved ranibizumab and aflibercept for nAMD and DME; FDA-approved brolucizumab for nAMD; and off-label bevacizumab for both conditions. [3][4][5][6] Landmark trials suggest that these agents have comparable safety and efficacy in their respective indications; [7][8][9][10][11][12] therefore, treatment preferences among physicians and patients may instead be driven by other factors, such as differences in cost and labeled injection frequency.…”