A 55-year-old woman with type 2 diabetes for 12 years undergoes fundus screening. The image shows microaneurysms, hard exudates, and a few dot-blot hemorrhages in both eyes, with no neovascularization. According to the International Clinical Diabetic Retinopathy Severity Scale, how is this classified?

• A Moderate non-proliferative diabetic retinopathy ✓
• B Mild non-proliferative diabetic retinopathy
• C Severe non-proliferative diabetic retinopathy
• D Proliferative diabetic retinopathy

Explanation

The presence of microaneurysms, hard exudates, and dot-blot hemorrhages places this in moderate NPDR. Mild NPDR (option B) shows only microaneurysms. Severe NPDR (option C) requires the 4-2-1 rule: severe hemorrhages in four quadrants, venous beading in two quadrants, or IRMA in one quadrant. PDR (option D) requires neovascularization or vitreous hemorrhage.

Reference: Wilkinson CP, Ferris FL III, et al. International Clinical Diabetic Retinopathy Severity Scale, Ophthalmology 2003 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.