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The people who deserve extra attention usually include: Patients with a known history of diabetic retinopathy Patients with diabetic macular edema Patients with recently worsening retinopathy Patients with poor baseline glucose control who may experience a large A1c drop Patients starting semaglutide while already under retina treatment Patients with multiple high-risk features such as kidney disease, hypertension, or long-standing diabetes In contrast, a patient with type 2 diabetes, no known retinopathy, and a recent normal dilated exam may still need routine follow-up—but often not the same level of concern as someone with active retinal disease

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If initial requirements appear to be met, the prescriber receives a prior authorization request