Classifying Diabetic Retinopathy

Diabetic retinopathy (DR) is a common complication of diabetes (type 1 or 2).1 It is the manifestation of end-organ damage from diabetes in the eye.2 Classically, DR was considered a microvascular disease of the retina, but newer research suggests neurodegeneration is present before the microvascular anomalies can be seen.1

There are 4 stages of diabetic retinopathy3

  • Mild nonproliferative diabetic retinopathy (mild NPDR): Small outpouchings of the retinal vascular wall, called microaneurysms, are present in the retina.
  • Moderate nonproliferative diabetic retinopathy (moderate NPDR): More microaneurysms are present. Mild vascular changes that affect the shape and structure of the retinal blood vessels, small areas of bleeding (called dot and blot hemorrhages) and soft exudates may also be present in the retina.
  • Severe nonproliferative diabetic retinopathy (severe NPDR): Microaneurysms and/or bleeding is present in all areas of the retina and/or more significant vascular changes are present.
  • Proliferative diabetic retinopathy (PDR): The growth of fragile, abnormal retinal blood vessels (neovascularization [NV]) is present in the eye. The new blood vessels can grow in the on the optic disc (NVD), iris (NVI), filtration angle (NVA) or retina (NVE).

In addition to the stages listed above, the presence or absence of diabetic macular edema (DME) will be documented. DME can develop at any stage of DR. It is swelling in the macula (the area of the retina responsible for central vision) due to leaky, damaged retinal blood vessels.3

Prevalence of diabetic retinopathy:


Scroll to Top

Scientific Council

Neil M. Bressler, MD

James P. Gills Professor of Ophthalmology
Professor of Ophthalmology, Johns Hopkins University School of Medicine
Wilmer Eye Institute, Johns Hopkins Medicine
Baltimore, MD

A. Paul Chous, MA, OD, FAAO

Specializing in Diabetes Eye Care & Education, Chous Eye Care Associates
Adjunct Professor of Optometry, Western University of Health Sciences
AOA Representative, National Diabetes Education Program
Tacoma, WA

Steven Ferrucci, OD, FAAO

Chief of Optometry, Sepulveda VA Medical Center
Professor, Southern California College of Optometry at Marshall B. Ketchum University
Sepulveda, CA

Julia A. Haller, MD

Wills Eye Hospital
Philadelphia, PA

Allen C. Ho, MD, FACS

Director, Retina Research
Wills Eye Hospital
Professor and Chair of the Department of Ophthalmology
Thomas Jefferson University Hospitals
Philadelphia, PA

Charles C. Wykoff, MD, PhD

Director of Research, Retina Consultants of Houston
Associate Professor of Clinical Ophthalmology
Blanton Eye Institute & Houston Methodist Hospital
Houston, TX

Diabetes Educators Scientific and Educational Toolkit

The RELIEF Diabetes Educators Toolkit is an online resource that aims to provide clinically relevant information and various educational tools about the recognition and diagnosis of diabetic retinopathy (DR), treatment strategies, and resources to enhance collaborative eye care. Click on one of the options below to learn more about DR and ways to help maintain healthy vision in patients with diabetes.

This activity for Diabetic Retinopathy education is provided by Med Learning Group.
This activity is supported by an independent medical education grant from Regeneron Pharmaceuticals, Inc.

Copyright © 2019 | Diabetic Retinopathy | All Rights Reserved | Website by Divigner