A 52-year-old man with type 2 diabetes for 18 years presents with bilateral high-risk proliferative diabetic retinopathy (PDR) as per Early Treatment Diabetic Retinopathy Study (ETDRS) criteria. He is planned for bilateral pan-retinal photocoagulation (PRP). Which of the following is classified as high-risk PDR by ETDRS?
- A New vessels elsewhere (NVE) > 1/2 disc area without haemorrhage
- B Preretinal haemorrhage with moderate NPDR
- C New vessels on the disc (NVD) > 1/4 disc area with vitreous haemorrhage ✓
- D Cotton wool spots with intraretinal microvascular abnormalities only
Correct answer: C. New vessels on the disc (NVD) > 1/4 disc area with vitreous haemorrhage
Explanation
ETDRS defined high-risk PDR as: (1) NVD ≥ 1/4–1/3 disc area; (2) any NVD with vitreous/preretinal haemorrhage; or (3) NVE ≥ 1/2 disc area with vitreous/preretinal haemorrhage. NVE alone >1/2 disc area without haemorrhage does not meet high-risk criteria. Cotton wool spots with IRMA represent severe NPDR (4:2:1 rule), not PDR.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.