Dawaa Reference

chronic

Retinopathy

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Diabetic Retinopathy - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK560805/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class FD67 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Retinopathy - disease-level clinical article (retinopathy-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (4)

  • Early disease can be silent, sometimes only picked up incidentally on a fundus exam.
  • As it progresses, blurred or distorted vision, floaters, and partial to complete vision loss can develop. [floaters]
  • What drives it worse: poor sugar control, uncontrolled blood pressure, abnormal lipids, kidney disease, male sex and obesity [obesity]
  • Red flag: it is the leading cause of severe sight loss in adults of working age [loss of vision]

Signs — what you find (8)

  • Microaneurysms are the earliest lesion an exam can pick up, though ones under about 30 micrometers may be too small to see clinically.
  • The smallest microaneurysms, under roughly 30 micrometers across, may not be visible on clinical exam.
  • Small hemorrhages within the retina come from ruptured weak capillary walls, with superficial flame-shaped bleeds arising from a different, more superficial vessel layer. [bleeding]
  • Hard exudates - lipid deposits - typically form a ring around a leaking microaneurysm.
  • Cotton wool spots represent tiny infarcts of the small precapillary blood vessels.
  • Retinal veins can show dilation, looping, beading, or a sausage-like segmented appearance on exam.
  • New vessels growing on the iris signal a poor prognosis and a tendency toward neovascular glaucoma.
  • Severe non-proliferative disease is defined by severe hemorrhages across all four retinal quadrants, venous beading in at least two quadrants, or marked IRMA in at least one quadrant.

Tests (8)

  • A fasting glucose of 126 mg/dL or higher on two separate occasions confirms diabetes, versus 110 to 125 for prediabetes.
  • HbA1c should be kept under 7 percent, with a normal range of roughly 4 to 5.6 percent.
  • A complete ocular workup includes visual acuity, eye pressure, gonioscopy to check for iris neovascularization, slit-lamp exam, and a dilated fundus exam to grade the retinopathy.
  • Fluorescein angiography can pin down ischemic maculopathy, map areas where capillaries have dropped out, tell IRMA apart from true new vessels, and reveal occult neovascularization not seen on exam.
  • OCT of the macula measures retinal thickening, tracks how edema responds to treatment, and can diagnose traction or a membrane that might need surgery.
  • B-scan ultrasound is valuable when the view is hazy, checking for vitreous hemorrhage, tractional detachment, or posterior vitreous detachment.
  • OCT angiography maps blood flow in the retina without an injected dye, similar to fluorescein angiography.
  • Caught early and treated promptly, most patients keep useful vision

If not this — what else fits (4)

  • Hypertensive retinopathy and central or branch retinal vein occlusion are part of the differential for the macular edema seen here.
  • A ruptured microaneurysm or macular edema from an epiretinal membrane can also produce a similar picture.
  • A retinal macroaneurysm or thalassemia-related retinopathy can likewise be mistaken for it on general fundus appearance.
  • Uncontrolled diabetes damages the eye in other ways too, so think of cataract, glaucoma, a dry surface, recurrent stye, ischaemic optic neuropathy and diabetic papillopathy

SourceStatPearls "Diabetic Retinopathy" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

General term for retinal damage; in Egypt the dominant drivers are diabetic and hypertensive retinal disease, both very common given local diabetes and hypertension rates. A GP's role is optimising the underlying disease (already covered under those separate conditions) and referring promptly to ophthalmology for retina-specific treatment such as laser or intravitreal therapy, which a GP does not prescribe. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

General term for retinal damage; in Egypt the dominant drivers are diabetic and hypertensive retinal disease, both very common given local diabetes and hypertension rates. A GP's role is optimising the underlying disease (already covered under those separate conditions) and referring promptly to ophthalmology for retina-specific treatment such as laser or intravitreal therapy, which a GP does not prescribe.

Cautions
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Delay in proper follow-up and evaluation can lead to permanent, irreversible vision loss.
  • RED FLAG - Sudden vision loss, new floaters or flashes suggesting retinal detachment, or rapid vision decline in a known diabetic or hypertensive patient.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.