Vietnam Association of Diabetes and Endocrinology – VADE Vietnam Association of Diabetes and Endocrinology – VADE
BUI PHUONG THAO, MD, Specialist level II
1. Definition and warning signs of diabetic retinopathy
- Diabetic retinopathy (DR) is a complication of diabetes where the blood vessels of the retina are damaged, which can cause bleeding, plasma leakage, and the development of new blood vessels, forming fibrous scar tissue that leads to vision reduction or loss. The disease can occur in people with type 1 and type 2 diabetes, as well as those with gestational diabetes.
- DR is one of the leading causes of vision impairment and blindness worldwide. Some recent studies show that about 20% to 35% of people with diabetes have DR.
- The disease progresses silently, and early stages often have no symptoms. Most patients with DR are unaware until it progresses to a severe stage, which cannot be fully reversed even with treatment. Therefore, patients should get an eye exam immediately if they experience any signs such as: blurred vision, distorted vision, dark spots or floaters, glare, or sudden vision loss.
2. Who is at high risk for diabetic retinopathy?
– The longer the duration of diabetes, especially over 5 years or if the onset of the disease is unknown.
– Persistently high blood sugar/HbA1c, high blood pressure, dyslipidemia, or having diabetic kidney complications.
– History of diabetic retinopathy, macular edema, or previous laser treatment or intraocular injections.
– Women who have had diabetes before becoming pregnant or are planning to get pregnant should consult a doctor about an eye exam schedule.
3. Frequency of routine eye exams for diabetic patients
| Type of Diabetes | Initial exam | Routine exam |
| Type 1 Diabetes | 5 years after diagnosis | – If no DR present: annual exam
– As soon as abnormal symptoms occur – Before pregnancy or when planning to get pregnant |
| Type 2 Diabetes | Immediately upon diagnosis | |
| Pre-existing DR or macular edema | Follow-up at least annually or more frequently depending on disease severity; immediate exam upon abnormal symptoms. | |
4. Management and monitoring
- Maintain good control of blood sugar, blood pressure, and blood lipids; follow prescribed medication treatments and do not arbitrarily stop medication.
- Upon detecting retinopathy, undergo treatment as advised by a specialist, such as retinal laser therapy, intraocular injections, or surgery for severe complications. The earlier the treatment, the better the chances of preserving vision.
- Attend primary care and specialist eye exams as scheduled, or immediately upon experiencing abnormal symptoms.
- Always prepare old medical records, prescriptions, or photos/monitoring apps when visiting the doctor, and note the time for your follow-up appointment.
References
- Ministry of Health. Decision No. 5481/QD-BYT dated December 30, 2020, issuing the professional document “Guidelines for the diagnosis and treatment of type 2 diabetes”; amended and supplemented by Decision No. 1353/QD-BYT dated February 23, 2021.
- Ministry of Health. Decision No. 2558/QD-BYT dated September 20, 2022, issuing the professional document “Guidelines for the diagnosis, treatment, and management of Diabetic Retinopathy”.
- American Diabetes Association Professional Practice Committee. 12. Retinopathy, Neuropathy, and Foot Care: Standards of Care in Diabetes – 2026. Diabetes Care. 2026;49(Suppl. 1):S261-S279.
