Diabetic Retinopathy Severity (ICDR Scale)

Diabetic retinopathy severity, International Clinical Diabetic Retinopathy (ICDR) scale.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Venous beading in ≥2 quadrants
Yes

Result: ICDR grade 4 of 5 (severe NPDR): the 4-2-1 rule is met.

The tool opens with these values already filled in. Replace them with your own.

What the result means

1
No apparent retinopathy: no abnormalities on dilated fundus exam.
2
Mild NPDR: microaneurysms only.
3
Moderate NPDR: more than microaneurysms alone but less than severe NPDR.
4
Severe NPDR (4-2-1 rule): >20 intraretinal hemorrhages in each of 4 quadrants, or venous beading in ≥2 quadrants, or IRMA in ≥1 quadrant, with no PDR.
5
Proliferative DR: neovascularization and/or vitreous or preretinal hemorrhage.

What you enter

  • Neovascularization
  • Vitreous or preretinal hemorrhage
  • >20 intraretinal hemorrhages in each of 4 quadrants
  • Venous beading in ≥2 quadrants
  • Prominent IRMA in ≥1 quadrant
  • Findings beyond microaneurysms (below severe)
  • Microaneurysms present
How this is calculated

Wilkinson CP, Ferris FL 3rd, Klein RE, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003;110(9):1677-1682. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.