nonproliferativ

Nonproliferativ is a term used in medical language to describe a form or stage of disease in which there is no active tissue or cellular proliferation. It is most commonly encountered in ophthalmology in reference to nonproliferative diabetic retinopathy (NPDR), the early stage of diabetic retinopathy that precedes proliferative diabetic retinopathy (PDR).

In NPDR, retinal vascular changes are present without neovascularization. Typical findings include microaneurysms, intraretinal hemorrhages (dot-blot), hard exudates, and cotton-wool spots. The condition is commonly categorized as mild, moderate, or severe NPDR, with severe cases carrying a higher risk of progression to PDR. Venous beading and intraretinal microvascular abnormalities (IRMA) are important features that influence severity assessment. Diabetic macular edema can occur at any NPDR stage and is a major cause of vision loss if it involves the macula.

Diagnosis is based on a dilated fundus examination and retinal imaging, such as color fundus photography and optical coherence tomography (OCT) to assess macular edema. Fluorescein angiography may be used selectively to evaluate retinal perfusion and guide management.

Management focuses on systemic risk factor control (glycemic, blood pressure, and lipid management) and regular ophthalmic monitoring. Diabetic macular edema present in NPDR may be treated with intravitreal anti-VEGF injections or laser therapy. In eyes with high risk features or progression toward PDR, panretinal photocoagulation may be indicated. The prognosis depends on disease severity and systemic control, with many NPDR cases remaining stable with proper care.