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World J Diabetes. Dec 15, 2013; 4(6): 290-294
Published online Dec 15, 2013. doi: 10.4239/wjd.v4.i6.290
Classification of diabetic retinopathy and diabetic macular edema
Lihteh Wu, Priscilla Fernandez-Loaiza, Johanna Sauma, Erick Hernandez-Bogantes, Marissé Masis
Lihteh Wu, Erick Hernandez-Bogantes, Marissé Masis, Vitreoretinal Section, Instituto de Cirugía Ocular, San José 1225, Costa Rica
Priscilla Fernandez-Loaiza, Johanna Sauma, Erick Hernandez-Bogantes, Marissé Masis, Department of Ophthalmology, Hospital México, San José 1000, Costa Rica
Johanna Sauma, Department of Ophthalmology, Hospital Calderón Guardia, San José 1000, Costa Rica
Author contributions: Wu L divided the assignment between the coauthors, edited the manuscript and checked it for accuracy; Fernandez-Loaiza P obtained the images; Sauma J researched and summarized the Airlie House Classification; Hernandez-Bogantes E researched and summarized the International Clinical Disease Severity Scale; Masis M worked on the Fluorescein Angiographic Classification.
Correspondence to: Lihteh Wu, MD, Vitreoretinal Section, Instituto de Cirugía Ocular, San José 1225, Costa Rica. lw65@cornell.edu
Telephone: +506-2256-2134 Fax: +506-2256-2128
Received: December 27, 2012
Revised: April 22, 2013
Accepted: April 28, 2013
Published online: December 15, 2013
Abstract

The global incidence and prevalence of diabetes mellitus (DM) have reached epidemic proportions. Estimates indicate that more than 360 million people will be affected by DM by 2030. All of these individuals will be at risk of developing diabetic retinopathy (DR). It is extremely important to categorize, classify and stage the severity of DR in order to establish adequate therapy. With proper management more than 90% of cases of visual loss can be prevented. The purpose of the current paper is to review the classification of DR with a special emphasis on the International Clinical Disease Severity Scale for DR. This new classification is simple to use, easy to remember and based on scientific evidence. It does not require specialized examinations such as optical coherence tomography or fluorescein angiography. It is based on clinical examination and applying the Early Treatment of Diabetic Retinopathy Study 4:2:1 rule.

Keywords: Diabetic retinopathy classification, Diabetic macular edema classification, International clinical disease severity scale, Diabetic macular edema, Diabetic retinopathy

Core tip: The International Clinical Disease Severity Scale for diabetic retinopathy has been proposed to facilitate communication between diabetic care givers. This new classification is simple to use, easy to remember and based on scientific evidence. It does not require specialized examinations such as optical coherence tomography or fluorescein angiography. It is based on clinical examination and applying the Early Treatment of Diabetic Retinopathy Study 4:2:1 rule.