Diabetic retinopathy (DR) may progress through a series of stages. Aiello et al listed clinical findings for each stage. The authors are from Harvard Medical School, Milton S. Hershey Medical Center and Penn State University.
Diabetic retinopathy is divided into nonproliferative and proliferative types. The early and middle stages involve nonproliferative lesions, while the advanced stages involve proliferative lesions.
|
Retinal Finding |
Stage of Diabetic Retinopathy |
|
appearance of retinal vascular microaneurysm |
early (mild nonproliferative) |
|
retinal blot hemorrhages |
early (mild nonproliferative) |
|
cotton wool spots |
early (mild nonproliferative) |
|
increased permeability of retinal vessels |
early (mild nonproliferative) |
|
beading or changes in the calibers of retinal veins |
middle (moderate to very severe nonproliferative) |
|
intraretinal microvascular abnormalities (IRMA) |
middle (moderate to very severe nonproliferative) |
|
loss of retinal capillaries |
middle (moderate to very severe nonproliferative) |
|
retinal ischemia |
middle (moderate to very severe nonproliferative) |
|
intra-retinal hemorrhages |
middle (moderate to very severe nonproliferative) |
|
extensive microaneurysms |
middle (moderate to very severe nonproliferative) |
|
new vessel proliferation on the optic disc (NVD) |
advanced (proliferative) |
|
new vessel proliferation on the retina elsewhere from the optic disc (NVE) |
advanced (proliferative) |
|
neovascularization of the iris |
advanced (proliferative) |
|
neovascular glaucoma |
advanced (proliferative) |
|
preretinal and/or vitreous hemorrhage |
advanced (proliferative) |
|
fibrovascular proliferation |
advanced (proliferative) |
|
retinal traction and/or tears |
advanced (proliferative) |
|
retinal detachment |
advanced (proliferative) |
Specialty: Ophthalmology, Endocrinology
