Skip to content
ClinCalc Pro
Menu
ophthalmology endocrinology general-medicine

ICDR — International Clinical Diabetic Retinopathy Severity Scale

Globally adopted clinical classification of diabetic retinopathy (Wilkinson 2003, AAO 2017). Drives screening interval and laser/anti-VEGF decisions. Combine with diabetic macular oedema (DMO) staging.

Score interpretation

No DR (R0) 0

→ Annual diabetic eye-screening service appointment. Optimise HbA1c, BP, lipids.

Mild NPDR (R1) 1

→ Annual screening. Tighten metabolic control. No ophthalmology referral unless DMO present.

Moderate NPDR (R2 in UK NSC) 2

→ Refer to hospital eye service within 13 weeks (HES). Annual / 6-monthly review.

Severe NPDR (R2/R3-A) 3

→ HES referral within 4 weeks. ~50% progress to PDR within 1 year — consider early panretinal photocoagulation (PRP) or close 3-monthly review.

PDR (R3) 4

→ Urgent (<1 week) HES referral. PRP ± intravitreal anti-VEGF (ranibizumab, aflibercept) per NICE TA346/824. Vitrectomy if vitreous haemorrhage non-clearing or tractional retinal detachment.

Interpretation bands for the ICDR. 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.