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
→ Annual diabetic eye-screening service appointment. Optimise HbA1c, BP, lipids.
→ Annual screening. Tighten metabolic control. No ophthalmology referral unless DMO present.
→ Lower-risk R2 features (8 or more blot haemorrhages, venous beading in 1 quadrant, IRMA less than ETDRS standard 8a) go to digital surveillance in the NHS DESP; otherwise routine screening. Tighten metabolic control.
→ Refer to the hospital eye service (NHS DESP: higher-risk R2 is always referred). ~50% progress to PDR within 1 year — consider early panretinal photocoagulation (PRP) or close 3-monthly review.
→ Urgent hospital eye service referral (R3A). PRP ± intravitreal anti-VEGF (ranibizumab, aflibercept). 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.
- Acute Red Eye / Vision Loss Screen · RCOphth 2020; NICE CKS
- Idiopathic Intracranial Hypertension · ABN; consensus 2018
- Acute Red Eye Assessment · RCOphth / AAO
- Acute Angle Closure Glaucoma · RCOphth / EGS Guidelines
- Retinal Detachment · RCOphth Guidelines / EURETINA
- Diabetic Retinopathy — Screening and Management · NICE NG28 2016 / NHS DES Programme
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.