31 Nonproliferative diabetic retinopathy (NPDR)Diabetic retinopathynonproliferativeNonproliferative Diabetic Retinopathy

The staging of nonproliferative diabetic retinopathy remains an important tool for directing follow-up regimens and estimating prognosis. Until recently, maximal systemic glucose control was the only treatment option, and that was generally considered to be for prevention of progression to more severe stages, especially proliferative retinopathy. The Early Treatment Diabetic Retinopathy Study (ETDRS) recommended consideration of panretinal laser before the appearance of proliferative retinopathy. Association with macular edema is still the most important determinant of treatment, but recent studies of the DRCR Network have demonstrated improvement in the degree of nonproliferative retinopathy, and might be a more important treatment goal in the future.