International clinical diabetic macular edema disease severity scale

Proposed disease severity level	Findings on dilated ophthalmoscopy
DME absent	No retinal thickening or hard exudates present in the posterior pole
DME present	Some retinal thickening or hard exudates present in the posterior pole
If DME is present, it can be categorized as follows
Proposed disease severity level	Findings observable on dilated ophthalmoscopy*
Mild DME	Some retinal thickening or hard exudates in posterior pole but distant from the center of the macula
Moderate DME	Retinal thickening or hard exudates approaching the center of the macula but not involving the center
Severe DME	Retinal thickening or hard exudates involving the center of the macula

*Hard exudates are a sign of current or previous macular edema. DME is defined as retinal thickening, and this requires a 3-dimensional assessment that is best performed through a dilated pupil examination using slit-lamp biomicroscopy with an accessory lens and/or stereo fundus photography. DME: Diabetic macular edema