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ophthalmology endocrinology

Diabetic Macular Oedema (DMO) Classification

Classification of diabetic macular oedema combining historical ETDRS clinically significant macular oedema (CSME) criteria with modern OCT-based centre-involving (CI-DMO) versus non-centre-involving (NCI-DMO) terminology. Drives anti-VEGF / laser decisions.

Used in: Diabetes & DKA

Score interpretation

No DMO 0

→ Routine screening interval per DR grade. Optimise HbA1c, BP, lipids.

NCI-DMO 1

→ Hospital eye service referral within 13 weeks. Observation with OCT every 4–6 months. Focal/grid laser if exudate threatens fovea.

CI-DMO without central thickening 2

→ Per DRCR.net Protocol V — observation with monthly visits is acceptable if VA ≥6/7.5. Initiate anti-VEGF if VA drops or central thickness increases.

CI-DMO with central thickening 3–4

→ Intravitreal anti-VEGF (ranibizumab, aflibercept, faricimab, brolucizumab) per NICE TA346/824/989. Loading 4–6 monthly injections then PRN/T&E. Sustained-release dexamethasone implant (Ozurdex) if pseudophakic / poor anti-VEGF response. Consider focal laser for refractory non-centre fluid.

Interpretation bands for the DMO. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.