Table 2.
Innovative Network for Sight Research Diabetic Eye Screening Study image grade, description, and recommendations based on the National Health System Grading Classification System and American Academy of Ophthalmology Recommendations, United States.
| Grade | Description | Recommendation |
|---|---|---|
| R0 | No DR | Re-evaluate in 12 months with either eye care specialist or photographic screening |
| None | ||
| Isolated cotton wools spots (≥1) in the absence of any microaneurysm or hemorrhage | ||
| R1 | Background DR | Refer to eye care provider |
| ≥1 microaneurysm(s) | ||
| ≥1 retinal hemorrhage(s) | ||
| Any exudates caused by DR | ||
| R2 | Pre-proliferative DR | Refer to ophthalmologist promptly |
| Intra-retinal microvascular abnormality | ||
| Venous beading | ||
| Venous loop or reduplication | ||
| Multiple deep, round or blot hemorrhages | ||
| R3 | Proliferative DR | Refer to ophthalmologist promptly |
| New vessels on the disc | ||
| New vessels elsewhere | ||
| Pre-retinal or vitreous hemorrhage | ||
| Pre-retinal fibrosis with or without tractional retinal detachment due to DR | ||
| M | Maculopathy | Refer to ophthalmologist promptly |
| Exudate within 1DD of the center of the fovea | ||
| Circinate or group of exudates within the macula | ||
| Any microaneurysm or hemorrhage within 1DD of the center of the fovea only if associated with a best visual acuity 20/40 or worse | ||
| P | Photocoagulation | Refer to eye care provider |
| Focal/grid to macula | ||
| Peripheral scatter | ||
| U | Unclassifiable/ungradable | Refer to eye care provider |
| Due to poor photographic location, focus, or contrast |
DR, diabetic retinopathy; DD, disc diameter.