5
Table 3. Recommended Eye Examinations for Patients With
Diabetes Mellitus and No Diabetic Retinopathy
Diabetes Type
Recommended Initial
Evaluation Recommended Follow-up
a
Type 1 5 years aer diagnosis Yearly
Type 2 At time of diagnosis Yearly
Pregnancy
b
(Type 1 or Type 2)
Soon aer conception
and early in the first
trimester
• No retinopathy to mild or
moderate NPDR: every 3–12
months
• Severe NPDR or worse: every
1–3 months
a
Abnormal findings may dictate frequent follow-up examinations.
b
Women who develop gestational diabetes do not require an eye examination during pregnancy and
do not appear to be at increased risk for diabetic retinopathy during pregnancy.
Ophthalmologic Examination
Î Both eyes should be classified according to the categories of diabetic
retinopathy and macular edema in Tables 1 & 2. (III, G, S)
Î Slit-lamp biomicroscopy is the recommended method to evaluate
retinopathy in the posterior pole and midperipheral retina. (III, G, S)
Î Examination of the peripheral retina is best performed with indirect
ophthalmoscopy or with slit-lamp biomicroscopy. (III, G, S)
Î Macular edema is best evaluated by dilated examination using slit-lamp
biomicroscopy, optical coherence tomography, and/or stereoscopic
fundus photography. (III, G, S)
Î Color fundus photography and optical coherence tomography (OCT)
imaging of the macular may occasionally be helpful to establish a
baseline for future comparison. (III, In, D)
Fundus Photography
Î If used appropriately, color and red-free fundus photography ancillary
to the clinical examination may enhance patient care. (III, In, D)
Î Color fundus photography is often helpful to document the status of the
retina even if laser surgery is not performed. (III, G, D)
