A patient with proliferative diabetic retinopathy (PDR) has high-risk characteristics (HRC). According to the Diabetic Retinopathy Study (DRS), which ONE of the following is a high-risk characteristic?
- A New vessels on disc (NVD) > 1/4 disc area with vitreous haemorrhage ✓
- B Soft exudates at the disc margin
- C Non-proliferative DR with 4-2-1 rule changes
- D Hard exudates within 500 μm of foveal centre
Correct answer: A. New vessels on disc (NVD) > 1/4 disc area with vitreous haemorrhage
Explanation
The DRS high-risk characteristics for severe visual loss include: NVD ≥ 1/4 to 1/3 disc area (with or without vitreous haemorrhage), or any NVD with vitreous haemorrhage, or NVE ≥ 1/2 disc area with vitreous haemorrhage. New vessels on disc (NVD) > 1/4 disc area with vitreous haemorrhage fulfils two HRC criteria and carries the highest risk. The 4-2-1 rule refers to NPDR severity, and hard exudates describe CSME.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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