A diabetic with proliferative retinopathy may be at risk for severe vision loss if certain high risk characteristics (HRC) are left untreated.
Patient selection: diabetic with proliferative retinopathy
Outcome: severe vision loss (visual acuity < 25/200)
High risk characteristics:
(1) NVD (new vessels on the optical disk or within 1 disk diameter) covering > 25% of the optic disk area
(2) NVD of any size AND (preretinal hemorrhage OR vitreous hemorrhage)
(3) NVE (new vessels elsewhere, i.e. not on the optic disk) occupying a cumulative area >= 50% of the optic disk area AND (preretinal hemorrhage OR vitreous hemorrhage)
where:
• In Klein et al the area for NVE is based on a single photographic field.
A patient with one or more high risk characteristics should undergo photocoagulation therapy if vision is to be preserved.
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