Table 3.

The grading system from the Early Treatment of Diabetic Retinopathy Study.

Level	Severity	Definitions	Scale step
10/10	DR absent	All diabetic retinopathy features absent	1
20/<20	MA only	Microaneurysm(s) only, other lesions absent, one eye	2
20/20	MA only	Microaneurysm(s) only, other lesions absent, both eyes	3
35/<35	Mild NPDR	MA plus retinal hemorrhage(s) and/or hard exudates and/or cotton wool spots, one eye	4
35/35	Mild NPDR	MA plus retinal hemorrhage(s) and/or hard exudates and/or cotton wool spots, both eyes	5
43/<43	Moderate NPDR	Lesions as above + either extensive or severe HMA or IRMA present, one eye	6
43/43	Moderate NPDR	Lesions as above + either extensive or severe HMA or IRMA present, both eyes	7
47/<47	Moderately severe NPDR	Lesions of 35 + either extensive or severe HMA with IRMA or venous beading, one eye	8
47/47	Moderately severe NPDR	Lesions of 35 + either extensive or severe HMA with IRMA or venous beading, both eyes	9
53/<53	Severe NPDR	Extensive and severe HMA, IRMA, and/or venous beading, one eye	10
53/53	Severe NPDR	Extensive and severe HMA, IRMA, and/or venous beading, both eyes	11
60, 61, 65, 71, 75, 81	Proliferative DR	NVD and/or NVE without or with complication	12+

DR = diabetic retinopathy; NPDR = nonprotective diabetic retinopathy; MA = microaneurysm; HMA = hemorrhages and microaneurysms; HE = hard exudates; CWS = cotton wool spots; IRMA = intraretinal microvascular abnormalities; NVD = new vessels on the disc; NVE = new vessels elsewhere.