According to the Diabetic Retinopathy Study (DRS) High-Risk Characteristics, which of the following alone carries the HIGHEST risk of severe visual loss necessitating urgent PRP?
- A New vessels at the disc (NVD) occupying one-quarter or more of disc area without vitreous haemorrhage ✓
- B New vessels elsewhere (NVE) less than half disc area with vitreous haemorrhage
- C Intraretinal microvascular abnormalities in two or more quadrants
- D Venous beading in one quadrant with hard exudates at macula
Correct answer: A. New vessels at the disc (NVD) occupying one-quarter or more of disc area without vitreous haemorrhage
Explanation
The DRS defined four high-risk characteristics (HRCs): NVD ≥1/4–1/3 disc area; any NVD with vitreous or preretinal haemorrhage; NVE ≥1/2 disc area with vitreous or preretinal haemorrhage. Presence of any two HRCs indicates very high risk. NVD ≥1/4 disc area even without haemorrhage constitutes a single HRC warranting PRP. IRMA and venous beading are ETDRS severe NPDR features, not proliferative HRCs.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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