International Standards:

International Clinical Diabetic Macular Edema Disease Severity Scale

October 2002

(Also available as a PDF file)

2 major levels, with subcategories for diabetic macular edema

Proposed Disease Severity Level	Findings Observable Upon Dilated Ophthalmoscopy
Diabetic Macular Edema Absent	No retinal thickening or hard exudates in posterior pole
Diabetic Macular Edema Present	Some retinal thickening or hard exudates in posterior pole

If diabetic macular edema is present, it can be categorized as follows:

Proposed Disease Severity Level	Findings Observable Upon Dilated Ophthalmoscopy*
Diabetic Macular Edema Present	Mild Diabetic Macular Edema Some retinal thickening or hard exudates in posterior pole but distant from the macula
	Moderate Diabetic Macular Edema Retinal thickening or hard exudates approaching the center of the macula but not involving the center
	Severe Diabetic Macular Edema Retinal thickening or hard exudates involving the center of the macula

* Hard exudates are a sign of current or previous macular edema. Diabetic macular edema is defined as retinal thickening and this requires a 3-dimensional assessment that is best performed by a dilated examination using slit-lamp biomicroscopy and/or stereo fundus photography.

A more detailed table for the International Clinical DME Disease Severity Scale is available, with more explanation of the disease severity levels, definition of CSME, and management options.

Please contact Flora Lum, MD at the American Academy of Ophthalmology, 1 415 561-8500.

(Also available as a PDF file)

Next: International Clinical Diabetic Retinopathy Disease Severity Scale Detailed Table
(PDF Version - 568 KB)

Also see:

• International Clinical Diabetic Retinopathy And Diabetic Macular Edema Disease Severity Scales
  (PDF Version - 88 KB)
  
  
• International Clinical Diabetic Retinopathy Disease Severity Scale
  (PDF Version - 44 KB)
  
  
• International Clinical Classification of Diabetic Retinopathy, Severity of Diabetic Macular Edema, Detailed Table
  (PDF Version - 56 KB)

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