Table 2.

International and English screening retinopathy classifications

‘International’ clinical classification [27]		English Screening Programme [48]
	Optimise medical therapy, screen at least annually	R0 Currently screen Annually
Ma’s only		R1 Screen annually Background Microaneurysm(s) or HMa Retinal haemorrhage(s) Venous loop Any exudate or cotton wool spots (CWS) in the presence of other non-referable features of DR
More than just micro aneurysms but less severe than severe NPDR	Refer to ophthalmologist
		R2 Refer to ophthalmologist Pre-proliferative Venous beading Venous reduplication Intraretinal microvascular abnormality (IRMA) Multiple deep, round or blot haemorrhages
Severe NPDR Any of the following: (a) Extensive intraretinal haem (>20) in 4 quadrants (b) Definite venous beading in 2+ quadrants (c) Prominent IRMA in 1+ quadrant And no signs of PDR	Consider Scatter photocoagulation for type 2 diabetes
Neovascularisation Vitreous/pre-retinal haemorrhage	Scatter Photocoagulation without delay for patients with vitreous haemorrhage or neovascularisation within 1 disc diameter of the optic nerve head	R3A Urgent referral to ophthalmologist R3A. Proliferative New vessels on disc (NVD) New vessels elsewhere (NVE) Pre-retinal or vitreous haemorrhage Pre-retinal fibrosis ± tractional retinal detachment
		R3S Follow-up annually within screening or at appropriate interval in surveillance R3S. Stable treated proliferative Evidence of peripheral retinal laser treatment AND Stable retina from photograph taken at or shortly after discharge from the hospital eye service (HES)