The Threshold of the Severity of Diabetic Retinopathy below Which Intensive Glycemic Control Is Beneficial in Diabetic Patients: Estimation Using Data from Large Randomized Clinical Trials
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.
