What are the grades of diabetic retinopathy?
1- Background Diabetic Retinopathy: Greater than 4 blot hemorrhages in one hemi-field. 2- Non-proliferative or Pre-proliferative Diabetic Retinopathy: Greater than 4 blot hemorrhages plus IRMA (intra-retinal microvascular anomalies) 3- Proliferative Diabetic Retinopathy: Neo-vascularization both at disc and elsewhere, viterous hemorrhages and retinal detachment.
Uncontrolled diabetes can cause multiple complications one of them is diabetic retinopathy. High blood sugar can lead to vessel blockage leading to decreased blood supply. When that occurs tissue tries to grow new blood vessels but this regeneration is not proper, blood leaks out into tissues. There are two types of retinopathy called early/ non proliferative diabetic retinopathy (no new vessel growth and micro aneurysms, nerve fibers swell ) and advanced retinopathy/ proliferative retinopathy ( damaged vessels completely blocked, new vessels grow which may leak, scar tissue forms, may lead to retinal detachment). Usually the condition is identified by direct ophthalmoscopy or slit lamp but another way available is digital photography. It is more sensitive. One retinal photograph is taken and then based on the signs the disease is graded for example based on presence of blot hemorrhages, exudates, venous beading. Retinopathy is graded from R0 to R6 and maculopathy is graded from M0 to M2.