{"id":2516,"date":"2009-03-06T12:10:04","date_gmt":"2009-03-06T12:10:04","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/dbtretina\/"},"modified":"2025-05-14T19:10:28","modified_gmt":"2025-05-14T19:10:28","slug":"dbtretina","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/dbtretina\/","title":{"rendered":"International Clinical Diabetic Retinopathy and Diabetic Macular Edema Disease Severity Scales"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>The levels in this new diabetic retinopathy disease severity scale consist of five scales with increasing risks of retinopathy.<br \/>\n<!--more--><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"width: 100%;\" colspan=\"2\" width=\"599\"><strong> International Clinical Diabetic Retinopathy Disease Severity Scale<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\">Proposed Disease Severity Level<\/td>\n<td style=\"width: 50%;\">Findings Observable upon Dilated Ophthalmoscopy<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\">No apparent retinopathy<\/td>\n<td style=\"width: 50%;\">No abnormalities<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\">Mild nonproliferative diabetic retinopathy<\/td>\n<td style=\"width: 50%;\">Microaneurysms only<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\">Moderate nonproliferative diabetic retinopathy<\/td>\n<td style=\"width: 50%;\">More than just microaneurysms but less than severe NPDR<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\">Severe nonproliferative diabetic retinopathy<\/td>\n<td style=\"width: 50%;\">Any of the following:<br \/>\nMore than 20 intraretinal hemorrhages in each of four quadrants<br \/>\nDefinite venous beading in two or more quadrants<br \/>\nProminent IRMA in one or more quadrants<br \/>\nAnd no signs of proliferative retinopathy<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\">Proliferative diabetic retinopathy<\/td>\n<td style=\"width: 50%;\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">One or both of the following:<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Neovascularization<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Vitreous\/preretinal hemorrhage<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"MsoNormal\">IRMA = intraretinal microvascular abnormalities; NPDR = nonproliferative diabetic retinopathy<\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr>\n<td style=\"width: 50%;\" colspan=\"2\"><strong>International Clinical Diabetic Macular Edema Disease Severity Scale<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\"><strong>Proposed Disease Severity Level<\/strong><\/td>\n<td style=\"width: 50%;\"><strong>Findings Observable upon Dilated <\/strong><strong>Ophthalmoscopy<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\">Diabetic macular edema apparently absent<\/td>\n<td style=\"width: 50%;\">No apparent retinal thickening or hard exudates in posterior pole<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\">Diabetic macular edema apparently present<\/td>\n<td style=\"width: 50%;\">Some apparent retinal thickening or hard exudates in posterior pole<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\" colspan=\"2\"><strong>If diabetic macular edema is present, it can be categorized as follows:<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\"><strong>Proposed Disease Severity Level<\/strong><\/td>\n<td style=\"width: 50%;\"><strong>Findings Observable upon Dilated Ophthalmoscopy*<\/strong><\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\">Diabetic macular edema present<\/td>\n<td style=\"width: 50%;\">Mild diabetic macular edema: Some retinal thickening or hard exudates in posterior pole but distant from the center of the macula<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\" colspan=\"2\">Moderate diabetic macular edema: Retinal thickening or hard exudates approaching the center of the macula but not involving the center<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 50%;\" colspan=\"2\">Severe diabetic macular edema: Retinal thickening or hard exudates involving the center of the macula<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"MsoNormal\">* Hard exudates are a sign of current or previous macular edema. Diabetic macular edema is defined as retinal thickening; this requires a three-dimensional assessment that is best performed by dilated examination using slit-lamp biomicroscopy and\/or stereo fundus photography.<\/p>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References: <\/strong><\/p>\n<ol>\n<li>Wilkinson CP, Ferris FL 3rd, Klein RE, Lee PP, Agardh CD, Davis M, Dills D, Kampik A, Pararajasegaram R, Verdaguer JT; Global Diabetic Retinopathy Project Group. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003 Sep;110(9):1677-82.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/13129861\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Ciulla TA, Amador AG, Zinman B. Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies. Diabetes Care. 2003 Sep;26(9):2653-64.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12941734\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: Sep 12, 2006<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[626],"tags":[812,490,211,1120,1119,51,1583,452,1304,1065,1582,1581,1060,1061,997,226,180],"class_list":["post-2516","post","type-post","status-publish","format-standard","hentry","category-diabetes","tag-clinica","tag-clinical","tag-diabetes","tag-diabetic","tag-diabetica","tag-disease","tag-edema","tag-escala","tag-internacional","tag-international","tag-macular","tag-ojo","tag-retinopathy","tag-retinopatia","tag-scales","tag-severidad","tag-severity"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2516","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2516"}],"version-history":[{"count":6,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2516\/revisions"}],"predecessor-version":[{"id":8957,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2516\/revisions\/8957"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2516"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2516"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2516"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}