MMCurrent Perspectives of Diabetic Retinopathy -- A photo essay for health professionals: http

• Retinopathy Stages: Images: http://www.retinopathyscreening.co.uk/pdf%27s/STAGES_OF_DIABETIC_RETINOPATHY.pdf; http://www.loc-net.org.uk/uploaded_files/115719864927779/assessing_images_for_retinopathy_level.pdf;http://www.ndrs.scot.nhs.uk/ClinGrp/Docs/Grading%20Scheme%202007%20v1.1.pdf;
• Wisconsin Retinopathy Grading Standards: http://eyephoto.ophth.wisc.edu/ResearchAreas/Diabetes/DiabStds.htm;
  
• Retinopathy Grading: eg: http://www.ndrs.scot.nhs.uk/ClinGrp/Docs/Grading%20Scheme%202007%20v1.1.pdf;
• R0=no visible retinopathy
  
• R1=mild BDR
• dot haemorrhages
• microaneurysm
• hard exudates
• CWS
• blot haemorrhages
• superficial/flame shaped haemorrhages
• R2=observable BDR
• 4+ blot haemorrhages in one hemifield (inf/sup) only -> rescreen in 6 mths
• R3=referable BDR
• 4+ blot haemorrhages in both hemifields (inf+sup) -> refer
• venous beading
• IRMA
• R4=proliferative DR (PDR)
• active NV
• vitreous haemorrhage
• R6=inadequate
• Maculopathy Grading: eg http://www.ndrs.scot.nhs.uk/ClinGrp/Docs/Grading%20Scheme%202007%20v1.1.pdf;
• M0=no visible maculopathy:
• no features ≤2 DD of centre of fovea
• M1=observable maculopathy:
• hard exudates >1 and ≤2 DD of centre of fovea
• M2=referable maculopathy
• hard exudates ≤1 DD of centre of fovea
• blot haemorrhages ≤1 DD of centre of fovea
• Maculopathy:
• M0.5 -> no referral needed
  
• M1
• Preproliferative: R2
• Proliferative: R3
• Disc New Vessels (DNV)
• New Vessels Elsewhere (NVE)
• End-stage diabetic retinopathy
• Features: http://www.loc-net.org.uk/uploaded_files/115719864927779/assessing_images_for_retinopathy_level.pdf;
• Microaneurysms
• Exudates [usu. with haemorrhages somewhere]; DD: Drusen [usu. without haemorrhages]
  
• DD: AMD [areas of hypopigmentation as paler patches around fovea or bright calcified drusen]
• DD: wet AMD: haemorrhages at macula in older person
• Haemorrhages:
• R1
• R1.5 -> 6 months review
  
• R2 (multiple, round, deep, "juicy")
• Roth spots: flame-shaped haemorrhages
• CWS:
  
• IRMA: like shunts running slightly chaotically between vessels
• NV: extremely chaotic, coming out into the vitreous
• Venous loops (R2): 
• Venous beading