Grading
for Women who are Pregnant and have Diabetes
Women who have diabetes and are also pregnant should be initially
photoscreened as early in 1st trimester as possible.
Grade |
Brief
Description |
Clinical
Signs |
Outcome |
| P0 |
No
Retinopathy or Macular Disease |
No
Retinopathy or Macular Disease ( R0 M0) |
Continue
2-Yearly Screening.
If Clinical Modifiers
present photoscreen 3-monthly for remainder of pregnancy
|
| P1 |
Minimal
|
Minimal
Retinopathy, No Macular Disease ( R1 M0) |
Photoscreen
a minimum of 3-monthly for remainder of Pregnancy. |
| P2 |
>Minimal |
More
than Minimal Retinopathy and / or Macular Disease
(>R1 >M0)
|
Referral
to ophthalmologist. |
Changes
to Referral Guidelines
Clinical Modifiers
The following table indicates when clinical modifiers may result in
earlier re-screening or referral
Clinical
Modifier |
Note |
Outcome |
Compliance
including ‘did not attend’ (Poor DNA) x 2 or greater
Very poorly controlled Diabetes, HBA1c > 9%
Duration of Diabetes
Rate of Progression of Retinopathy
Poorly controlled Hypertension of >144/82 (Evidence UKPDS)
Dyslipidemia
Renal Failure
Asymmetrical
|
|
Consider reducing
screening interval or referral |
| Ethnicity |
Where statistics indicate
the person may be at risk of retinopathy |
Consider reducing
screening interval or review |