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. Author manuscript; available in PMC: 2009 Nov 1.
Published in final edited form as: Ophthalmology. 2008 Nov;115(11):1859–1868. doi: 10.1016/j.ophtha.2008.08.023
Level 10: No retinopathy.
Level 21: Microaneurysms (MAs) only or retinal hemorrhages (H) or soft exudates in the absence of MAs.
Level 31: MAs and one or more of the following: venous loops 31 μm or greater; questionable soft exudate, intraretinal microvascular abnormalities (IRMA) or venous beading; and retinal H.
Level 37: MAs and one or more of the following: hard exudate and soft exudate.
Level 43: MAs and one or more of the following: H/MAs equaling or exceeding those in Standard Photo (SP) 1 in four or five fields; H/MAs equaling or exceeding those in SP 2A in one field; and IRMA in one to three fields.
Level 47: MAs and one or more of the following: both IRMA and H/MA characteristics from level 43; IRMA in four or five fields; H/MAs equaling or exceeding those in SP 2A in two or three fields; and venous beading in one field.
Level 53: MAs and one or more of the following: any two or three characteristics from level 47; H/MAs equaling or exceeding those in SP 2A in four or five fields; IRMA equaling or exceeding those in SP 8A; venous beading in two or more fields.
Level 60: Fibrous proliferations only.
Level 61: No evidence of levels 60 or 65 but scars of photocoagulation either in “scatter” or confluent patches, presumably directed at new vessels.
Level 65: PDR less than DR Study high-risk characteristics (DRS-HRC). Lesions as follows: new vessels elsewhere (NVE); new vessels on or within 1 disc diameter (NVD) of the disc graded less than SP 10A; or preretinal (PRH) or vitreous hemorrhage (VH) less than 1 disc area (DA).
Level 71: DRS-HRC. Lesions as follows: VH and/or PRH equaling or exceeding 1 DA; NVE equaling or exceeding one-half DA with VH and/or PRH; NVD less than SP 10A with VH and/or PRH; and NVD equaling or exceeding SP 10A.
Level 75: Advanced PDR, lesions as follows: NVD equaling or exceeding SP 10A with VH and/or PRH.
Level 85: End-stage PDR, lesions as follows: macular obscured by VH and/or PRH; retinal detachment at center of macula; phthisis bulbi; and enucleation secondary to complications of DR.