Addendum to "The Stages of Diabetic Retinopathy"

Addendum to "The Stages of Diabetic Retinopathy"

Below is an addendum to yesterday’s post.  I omitted a “comment” about the 4 stages of diabetic retinopathy.  I highlighted the change and pasted in the original post.  Sorry.


a)  Macular edema can be present in any 4 of the stages.  It is usually treated with laser treatment, but steroids or anti-VEGF medications may be useful, too.  Macular edema, also called diabetic macular edema (DME) or clinically significant macular edema (CSME) is not necessary for staging.

b)  The first 3 stages have the terms “non-proliferative” associated and, therefore, do not carry the possibility of blindness.  “Proliferative” disease is noted by the presence of neovascularization, which can cause retinal detachment and, thus, blindness.

c)  There is nothing to do for the “non-proliferative” phases of the disease.  Treatment is only needed for macular edema (any stage) and proliferative diabetic retinopathy (PDR).

d)  The stages of diabetic retinopathy are not necessary sequential, that is, a patient may have no retinopathy and then 6 months later, might show signs of having proliferative diabetic retinopathy.  Diabetic retinopathy may skip stages.


Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist

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