Professional Statements and Societal Positions Guidelines
American Diabetes Association - 2020
In 2020, the American Diabetes Association updated its guidelines on standards of medical care for diabetes. Included in the guidelines were specific recommendations for initial and subsequent screening examinations for retinopathy:
- "Adults with type 1 diabetes should have an initial eye examination by an ophthalmologist or optometrist within five (5) years after the onset of diabetes. (B)"
- "Individuals with type 2 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist at the time of the diabetes diagnosis. (B)"
- "Eye examinations should occur before pregnancy or in the first trimester in individuals with pre-existing type 1 or type 2 diabetes, and then these individuals should be monitored every trimester and for one (1) year postpartum as indicated by the degree of retinopathy. (B)"
- "If there is no evidence of retinopathy for one or more annual eye exams and glycemia is well controlled, then screening every 1–2 years may be considered. (B)"
- "Programs that use retinal photography (with remote reading or use of a validated assessment tool) to improve access to diabetic retinopathy screening can be appropriate screening strategies for diabetic retinopathy. Such programs need to provide pathways for timely referral for a comprehensive eye examination when indicated. (B)"
"Artificial intelligence systems that detect more than mild diabetic retinopathy and diabetic macular edema authorized for use by the FDA represent an alternative to traditional screening approaches. However, the benefits and optimal utilization of this type of screening have yet to be fully determined."
