Degree of diabetic retinopathy depends on -
High-Yield Explanation
Microaneurysms in the macular area (the earliest detectable lesion). Retinal haemorrhages both deep (dot and blot haemorrhages) and superficial haemorrhages (flame-shaped). Hard exudates-yellowish-white waxy-looking patches are arranged in clumps or in circinate pattern. These are commonly seen in the macular area. Retinal oedema characterized by retinal thickening. Cotton-wool spots (if > 8, there is high risk of developing PDR). Venous abnormalities, beading, looping and dilatation. Intraretinal microvascular abnormalities (IRMA). Dark-blot haemorrhages representing haemorr- hagic retinal infarcts. On the basis of severity of the above findings the NPDR has been fuher classified as under: 1. Mild NPDR At least one microaneurysm or intraretinal hemorrhage. Hard/soft exudates may or may not be present. 2. Moderate NPDR Moderate microaneurysms/intraretinal hemorr- hage. Early mild IRMA. Hard/soft exudates may or may not present. 3. Severe NPDR. Any one of the following Four quadrants of severe microaneurysms/ intraretinal hemorrhages. Two quadrants of venous beading. One quadrant of IRMA changes. 4. Very severe NPDR. Any two of the following Four quadrants of severe microaneurysms/ intraretinal hemorrhages. Two quadrants of venous beading. One quadrant of IRMA changes. Ref Comprehensive ophthalmology AK Khurana 4th edition page no 494