The diabetic retinopathy severity scale (DRSS) is a 13-step scale. Healthcare professionals can use the DRSS to measure the severity of diabetic retinopathy in people with diabetes.

Diabetic retinopathy (DR) is an eye condition that can affect individuals with diabetes. Without diagnosis and treatment, those with DR may have vision problems or sight loss.

The DRSS is a measurement system that healthcare professionals use to describe the severity of DR. They can also use it to track how a person’s DR changes with time.

Someone with DR may not have any symptoms at first. However, healthcare professionals can detect DR during regular eye tests and use treatments to prevent their vision from worsening. People can also help prevent DR by taking steps to manage their diabetes.

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The DRSS is a method healthcare professionals use to measureTrusted Source and describe a person’s DR.

DR is an eye condition that can affectTrusted Source people with diabetes, who may have high blood sugar levels. This can affect blood vessels in a person’s retina, which is a layer of tissue at the back of the eye. It senses light and sends signals to the brain, allowing them to see.

A person’s DR can progress over time, leading to an increased risk of vision loss. Over time, healthcare professionals have used several methods and scales to accurately classify and describe:

  • the stage of a person’s DR
  • how far it has progressed
  • how severe a person’s DR is

What are the stages and types of DR?

DR occurs through different stages of increasing severity. There are two main types of DR:

  • NPDR (non-proliferative diabetic retinopathy): People with NPDR may have no symptoms. NPDR can weaken or close off blood vessels in a person’s retina, causing swelling or reduced blood flow in the eye. Small bulges in the retinal blood vessels are known as microaneurysms.
  • PDR (proliferative diabetic retinopathy): A person’s NPDR may progress to PDR. This type causes new blood vessel growth on a person’s retina, which can bleed into other parts of the eye. PDR can also cause scarring. People with PDR may have several eye symptoms and eventually experience severe or total vision loss.

Read on to learn more about the differences between NPDR and PDR.

The Early Treatment Diabetic Retinopathy Study (ETDRS) scale

One mainTrusted Source DR scale is the Early Treatment Diabetic Retinopathy Study (ETDRS), which dividesTrusted Source a person’s DR into 13 numbered levels.

The scale measuresTrusted Source a person’s visual acuity (VA), which tests how well their eyes can make out shapes and details at a given distance. To measure VA, healthcare professionals useTrusted Source an eye test.

They ask a person to read letters from an eye chart known as an ETDRS chart. This chart has several rows of 5 letters, decreasing in size and, therefore, difficulty. The healthcare professional counts how many letters the person can read correctly at a given distance from the chart.

They then use this count to calculate a person’s ETDRS score. This score then describes the severity of and how far their DR has progressed for both eyes individually.

The best treatment for a person’s DR depends on its progression. Healthcare professionals can useTrusted Source the DRSS to:

The ETDRS DRSS scale dividesTrusted Source a person’s DR into 13 numbered levels. Each level describes a different stage of their DR.

LevelSeverity
10no DR
20very mild NPDR
35mild NPDR
43moderate NPDR
47moderately severe NPDR
53severe NPDR
61mild PDR
65moderate PDR
71high risk PDR
75high risk PDR
81advanced PDR
85advanced PDR
90ungradable PDR

Higher levels describe a person’s increasing risk of vision loss over time.

Treatments for DR includeTrusted Source:

  • medications that healthcare professionals inject into the eye, such as:
    • anti-vascular endothelial growth factor therapy drugs, including aflibercept, bevacizumab, or ranibizumab
    • corticosteroids
  • laser treatments to reduce swelling in a person’s eye by shrinking eye blood vessels and stopping leaking
  • vitrectomy, which involves eye surgery to remove and replace damaged parts of the eye

People with diabetes can also help prevent or delay DR. Healthcare professionals recommend an annual comprehensive dilated eye exam to detect DR early. People with diabetes can also help delay or prevent vision loss by:

  • managing their diabetes to keep their blood sugar within professionally recommended limits, by:
  • being physically active
  • dietary changed
  • taking medication that healthcare professionals recommend
  • maintaining a medically recommended weight
  • maintaining their blood pressure and cholesterol within medically recommended ranges

The diabetic retinopathy severity scale (DRSS) is a scale healthcare professionals use to measure the severity and progression of a person’s DR. One main DRSS is the Early Treatment Diabetic Retinopathy Study (ETDRS) scale.

Healthcare professionals use a standard eye test to measure a person’s ETDRS score. This helps them recommend the best treatment and helps them predict someone’s risk of DR eye complications.

Doctors may use several treatments to treat a person’s DR. However, people can take several steps to help prevent DR from developing. Healthcare professionals recommend people also have regular eye tests to help detect DR early.