INTERNATIONAL CLINICAL DIABETIC RETINOPATHY DISEASE SEVERITY SCALE

 

Table 2. International Clinical Diabetic Retinopathy Disease Severity Scale
Proposed Disease Severity Level	Findings Observable Upon Dilated Ophthalmoscopy
No apparent retinopathy	No abnormalities
Mild NPDR	Microaneurysms only (Figure 13)
Moderate NPDR	More than just microaneurysms but less severe NPDR
Severe NPDR	US Definition Any of the following (4-2-1 rule) and no signs of proliferative retinopathy: Severe intraretinal hemorrhages and microaneurysms in each of four quadrants Definite venous beading in 2 or more quadrants (Figure 14) Prominent IRMA in 1 or more quadrants (Figure 15) International Classification Any of the following and no signs of PDR More than 20 intraretinal hemorrhages in each of four quadrants Definite venous beading in two or more quadrants Prominent IRMA in one or more quadrants
PDR	One of both of the following: Neovascularization (Figure 10) Vitreous/preretinal hemorrhage (Figure 12)

IRMA = intraretinal microvascular abnormalities; NPDR = nonproliferative diabetic retinopathy; PDR = proliferative diabetic retinopathy

Source: American Academy of Ophthalmology Retina-Vitreous Panel. Preferred Practice Pattern® Guidelines. Diabetic Retinopathy. 

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