Assessment and Management of Diabetic Retinopathy : Clinical Guideline for Finnish Optometrists

Abstract

ABSTRACT Oulu University of Applied Sciences Master of Health Care, Clinical Optometry

Author: Nora Lehtimäki Title of the thesis: Assessment and Management of Diabetic retinopathy: Clinical Guideline for Finnish Optometrists Supervisors: Satu Elo and Tuomas Juustila Term and year of thesis completion: Spring 2025 Pages: 67

Purpose: The purpose of research development is to produce evidence-based material based on literature review about diabetic retinopathy and its most common findings. The thesis aims to create a clinical guideline for Finnish optometrists on assessing diabetic retinopathy. Diabetic retinopathy remains a leading cause of vision loss among working-age adults, making early detection and effective management essential. This guideline aims to support optometrists in identifying, assessing, and guiding the treatment of diabetic retinopathy in diabetic patients.

Methods: A narrative literature review was conducted to compile and analyse evidence-based international guidelines related to diabetic retinopathy. The theoretical background was structured to support Finnish optometrists in clinical practice, with a focus on early detection techniques and decision-making processes in patient management. The primary literature search was conducted via the EBSCOhost web source using the Academic Search Premier, CINAHL, and MEDLINE databases. This search resulted in 450 records, which were further exclusion. Ultimately, 11 guidelines were selected for analysis, as illustrated in the PRISMA 2020 Flow Diagram. Findings from the literature review managed the development phase of this research, resulting in a structured, evidence-based clinical guideline specifically designed to support Finnish optometrists in their approach to assessing and managing diabetic retinopathy.

Results: The result of this study provides Finnish optometrists a structured approach to identifying key clinical signs of diabetic retinopathy and evaluating disease severity. The guideline is organized into three main categories: anamnesis/ patient history, ocular examination, and patient education and referral to ophthalmologist. Each section outlines evidence-based practices for identifying clinical signs, determining disease severity, and making appropriate referrals. Additionally, the guideline emphasizes the importance of multidisciplinary collaboration with ophthalmologists to enhance patient outcomes and support early detection.

Conclusions: The developed clinical guideline provides a practical, evidence-based resource for Finnish optometrists in assessing and managing diabetic retinopathy. This guideline supports optometrists in their role within a multidisciplinary healthcare approach to prevent diabetic retinopathy progression and maintain patients' visual function. By applying these standardized practices, optometrists can contribute significantly to early detection, effective patient education, and timely intervention, ultimately reducing the risk of vision loss due to diabetic retinopathy among their diabetic patients.

Keywords: clinical guideline, diabetic retinopathy, diabetic retinopathy assessment, diabetic retinopathy management, optometrist