Updated recommendations include new diagnostic technology and treatment guidelines.

Diabetes affects the entire body and can result in long–term complications, including damage to the small blood vessels. Such damage can lead to problems in the retina of the eye, a condition known as diabetic retinopathy. The American Diabetes Association has issued updated guidelines on prevention, assessment and treatment of diabetic retinopathy for providers and for people with diabetes. The detailed recommendations are featured in the article, “Diabetic Retinopathy: A Position Statement by the American Diabetes Association,” to be published in the March 2017 issue of the journal Diabetes Care, and online on February 21, 2017.

The position statement includes information on advancements in diabetic retinopathy assessment and treatment methods, as well as improvements in managing diabetes that have developed since its prior diabetic retinopathy position statement in 2002. New diagnostic developments include the widespread adoption of optical coherence tomography, as well as intraretinal pathology and wide–?eld fundus photography. Newer treatment modalities, including intravitreous injection of anti–vascular endothelial growth factor agents, are also outlined in the statement.

“Diabetic retinopathy is actually the most common cause of new cases of blindness in adults who live in developed countries and are between the ages of 20 and 74,” said Thomas W. Gardner, MD, MS, corresponding author of the article and professor of ophthalmology and visual sciences at the Kellogg Eye Center at the University of Michigan.

“Over the past decade, new research and significant improvements in technology have aided our ability to diagnosis and treat diabetic retinopathy, and advances in medications are giving people with diabetes the opportunity to improve glucose management and potentially avoid or delay the progression of complications such as retinopathy.”

The position statement outlines the stages of diabetic retinopathy and highlights recommendations on optimal blood glycemic control and lowering blood pressure. The statement cites studies that have shown the positive effects tight glycemic control can have on diabetic retinopathy risks and progressions in patients with diabetes, and how those benefits can last for years.

Screening recommendations are also included in the statement, with the Association suggesting that adults with type 1 diabetes have a comprehensive eye exam within five years of the onset of diabetes, and that people with type 2 diabetes have an exam at the time of diagnosis.

Additionally, it is recommended that women with preexisting diabetes who are pregnant or planning to become pregnant should be educated on the risks of developing diabetic retinopathy. Specific diabetic retinopathy treatment and management recommendations are also outlined in the position statement.