Treatment of Diabetic Retinopathy in Severe NPDR or Non-High-Risk PDR

Clinical Scenario

This protocol applies to patients with diabetic retinopathy who have progressed to severe nonproliferative diabetic retinopathy (NPDR) or non-high-risk proliferative diabetic retinopathy (PDR).

Severe NPDR is diagnosed when defined disease signs progress beyond specific thresholds. Severe NPDR and non-high-risk PDR are addressed together because clinical trial data demonstrated they follow a similar course, and treatment recommendations for both stages are closely aligned.

Clinical Goal

The primary objective is a two-step or greater improvement in Diabetic Retinopathy Severity Scale (DRSS) level, reducing the risk of vision loss as retinopathy advances toward high-risk characteristics.

Treatment Approach (Partial Overview)

Patients at this stage are candidates for intervention aimed at reducing the risk of vision loss. The approach involves either a form of retinal laser surgery or an intravitreal injection therapy — the choice and timing depend on clinical factors including the presence of macular oedema and whether high-risk characteristics have yet developed.

The full regimen — including the specific interventions, sequencing criteria, and the evidence informing when treatment may be deferred or applied early — is available via the structured protocol below.