International Standards:

International Clinical Diabetic Retinopathy Disease Severity Scale

October 2002

(Also available as a PDF file)

5 Levels for Diabetic Retinopathy – none, mild, moderate, severe and proliferative

Proposed Disease Severity Level	Findings Observable upon Dilated Ophthalmoscopy
No Apparent Retinopathy	No abnormalities
Mild Non-Proliferative Diabetic Retinopathy	Microaneurysms only
Moderate Non-Proliferative Diabetic Retinopathy	More than just microaneurysms but less than Severe NPDR
Severe Non-Proliferative Diabetic Retinopathy	Any of the following: More than 20 intraretinal hemorrhages in each of 4 quadrants Definite venous beading in 2+ quadrants Prominent IRMA in 1+ quadrant And no signs of proliferative retinopathy
Proliferative Diabetic Retinopathy	One or more of the following: Neovascularization Vitreous/preretinal hemorrhage

More detailed table for the International Clinical DR Disease Severity Scale is available, with more explanation of the disease severity levels, linkages to the ETDRS levels, standard photographs, 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 Macular Edema Disease Severity Scale
(PDF Version - 48 KB)

Also see:

• Summary: International Clinical Diabetic Retinopathy And Diabetic Macular Edema Disease Severity Scales (PDF Version - 88 KB)
  
  
• International Clinical Diabetic Retinopathy Disease Severity Scale, Detailed Table (PDF Version - 568 KB)
  
  
• International Clinical Classification of Diabetic Retinopathy, Severity of Diabetic Macular Edema, Detailed Table (PDF Version - 56 KB)

To read or print the PDF files, you will need Adobe Reader, which is a free download