The Diabetic Retinopathy Study (DRS) defined 'high-risk characteristics' for severe visual loss. Which combination MOST correctly identifies these?
- A New vessels on the disc (NVD) ≥1/4–1/3 disc area, or any NVD with vitreous haemorrhage, or new vessels elsewhere (NVE) ≥1/2 disc area with vitreous haemorrhage ✓
- B Moderate NPDR plus macular edema
- C Any neovascularization with visual acuity worse than 6/60
- D Pre-retinal haemorrhage without neovascularization
Correct answer: A. New vessels on the disc (NVD) ≥1/4–1/3 disc area, or any NVD with vitreous haemorrhage, or new vessels elsewhere (NVE) ≥1/2 disc area with vitreous haemorrhage
Explanation
The DRS defined high-risk PDR characteristics as: NVD ≥1/4 to 1/3 disc area; or NVD of any size with vitreous or preretinal haemorrhage; or NVE ≥1/2 disc area with vitreous or preretinal haemorrhage. Presence of two or more of these features (or any single high-risk characteristic in the study) indicated a >50% risk of severe visual loss over 2 years without PRP. These criteria remain the classic threshold for initiating panretinal photocoagulation (PRP) in PDR.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
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