Nonproliferative Diabetic Retinopathy (NPDR)

Nonproliferative Diabetic Retinopathy 

  • Most common form of diabetic retinopathy.
  • After 20 years of the disease, almost 100% of patients with type 1 and 60% of type 2 have some degree of retinopathy.

Clinical features:

  • Signs:
    • Microaneurysm, intraretinal hemorrhages, cotton wool spots and hard exudates
    • Venous tortuosity or beading, capillary dropout and intraretinal microvascular abnormalities (IRMA)
    • Increasing formation of microaneurysm leads to increased vascular permeability of the retinal capillaries and result in retinal edema particularly in the macular area

Fluorescein angiography demonstrates:

  • Scattered hyperfluorescence dots of microaneurysms which can be associated with minimal dye leakage
  • Spots of hypofluorescense in the area of hemorrhages and exudates
  • Areas of irregular capillary pattern or capillary closure

Management:

  • Improve patients education and understanding about the disease process.
  • Control of blood glucose, cholesterol and blood pressure.
  • Photocoagulation in severe nonproliferative retinopathy.
  • Annual check-up 5 years after onset for patient aged less than 30 years old, and at time of diagnosis for patients aged 30 and older.
  • Frequency of scheduled check-up depends on the status of the retinopathy.