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Review
. 2013 Dec 15;4(6):290-4.
doi: 10.4239/wjd.v4.i6.290.

Classification of diabetic retinopathy and diabetic macular edema

Lihteh Wu  1 , Priscilla Fernandez-Loaiza  1 , Johanna Sauma  1 , Erick Hernandez-Bogantes  1 , Marissé Masis  1
Affiliations
Review

Classification of diabetic retinopathy and diabetic macular edema

Lihteh Wu et al. World J Diabetes. .

Abstract

The global incidence and prevalence of diabetes mellitus (DM) have reached epidemic proportions. Estimates indicate that more than 360 million people will be affected by DM by 2030. All of these individuals will be at risk of developing diabetic retinopathy (DR). It is extremely important to categorize, classify and stage the severity of DR in order to establish adequate therapy. With proper management more than 90% of cases of visual loss can be prevented. The purpose of the current paper is to review the classification of DR with a special emphasis on the International Clinical Disease Severity Scale for DR. This new classification is simple to use, easy to remember and based on scientific evidence. It does not require specialized examinations such as optical coherence tomography or fluorescein angiography. It is based on clinical examination and applying the Early Treatment of Diabetic Retinopathy Study 4:2:1 rule.

Keywords: Diabetic macular edema; Diabetic macular edema classification; Diabetic retinopathy; Diabetic retinopathy classification; International clinical disease severity scale.

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Figures

Figure 1
Figure 1
Standard photograph. A: 2A. Notice the intraretinal hemorrhages. If 4 quadrants have intraretinal hemorrhages of at least this magnitude then by definition severe non-proliferative retinopathy is present; B: 6A. Notice venous beading (VB). If 2 quadrants or more have VB of at least this magnitude then by definition severe non-proliferative retinopathy is present; C: 8A. Notice the intraretinal microvascular abnormalities (IRMA). If one or more quadrants has IRMA of at least this magnitude then by definition severe non-proliferative retinopathy is present.
Figure 2
Figure 2
Diabetic macular edema. A: Mild diabetic macular edema (DME). Notice that the hard exudates are located far from the center of the fovea; B: Moderate DME. Even though there is no thickening involving the center of the fovea, the hard exudates are threatening the center of the fovea; C: Severe DME. The center of the fovea is involved with hard exudate and thickening.
See this image and copyright information in PMC

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