Understanding national grading results and outcomes

Screening for diabetic retinopathy

NYDESP invite all eligible people with diabetes for an annual screening for diabetic eye disease. In some case we screen people more frequently (please see the table below) in our digital surveillance clinics for closer monitoring. We send the screening results to the person with diabetes and their GP.

Screening does not look for other eye conditions and we advise people with diabetes to continue to visit their optician regularly for an eye examination. However, if we see evidence of another eye condition which needs either urgent or routine assessment by an eye specialist, we refer directly to the local hospital.

If you need to find out when somebody is due screening or they have been referred to the local hospital, please contact us on 01904 726640. You will need the permission of the person you are enquiring about.

Grading outcomes

Grading result	Grade	Patient letter	Outcome
No retinopathy	R0M0	Results appeared normal	Annual recall
Background retinopathy	R1M0	Background Retinopathy	Annual recall
Maculopathy - low risk	R1M1	Maculopathy	Closer monitoring screening. 3, 6 or 9 month recall with OCT scan
Maculopathy - high risk	R1M1/ R3SM1	Maculopathy	Routine referral to an eye specialist. Appointment should be within 13 weeks of screening date
Pre-proliferative – low risk	R2M0	Pre-proliferative	Closer monitoring screening. 3, 6 or 9 month recall with multi-field photography
Pre-proliferative – high risk	R2M0	Pre-proliferative	Routine referral to an eye specialist. Appointment should be within 13 weeks of screening date
Pre-proliferative and maculopathy	R2M1	Maculopathy	Routine referral to an eye specialist. Appointment should be within 13 weeks of screening date
Proliferative	R3AM0 R3AM1	Proliferative	Urgent referral to an eye specialist. Appointment should be within 6 weeks of screening date
Treated stable proliferative	R3SM0	Treated stable proliferative	Closer monitoring screening. 3, 6 or 9 month recall with multi-field photography
Unassessable	U	Photographs were not clear enough	Referral to an SLB clinic. Appointment should be within 13 weeks of screening date

Table to show the possible results and outcomes

No retinopathy R0M0

The retina appears normal. The next appointment will be in routine digital screening in 12 months.

Background retinopathy R1M0

The retina shows small changes in the blood vessels which do not require treatment or closer monitoring. The next appointment will be in routine digital screening in 12 months.

Diabetic maculopathy – low risk R1M1

The retina shows maculopathy that does not require treatment. The next appointment will be in a surveillance clinic for closer monitoring. Closer monitoring screening for maculopathy is offered at either 3, 6 or 9 month intervals with 2 field photography and an OCT. The appointment is still in the community with the same screening staff, but it might not be at the local GP surgery.

Diabetic maculopathy – high risk R1M1/ R3SM1

The retina shows maculopathy that need further assessment or treatment. The next appointment will be at the local hospital with an eye specialist.

Pre-proliferative retinopathy (moderate) – low risk R2M0

The retina shows moderate pre-proliferative changes. The next appointment will be in a surveillance clinic for closer monitoring. Closer monitoring screening for pre-proliferative disease is offered at either 3, 6 or 9 month intervals with multi-field photography. We will take about 8 photographs of each eye so that we can see more of the retina. The appointment is still in the community with the same screening staff, but it might not be at the local GP surgery.

Pre-proliferative retinopathy (severe) – high risk R2M0 / R2M1

The retina shows severe pre-proliferative changes that need further assessment. The next appointment will be at the local hospital with an eye specialist. Severe pre-proliferative eye disease is more likely to progress to proliferative retinopathy that needs treatment within a year.

Proliferative retinopathy R3AM0 / R3AM1

The retina shows proliferative changes which need urgent assessment or treatment by an eye specialist. The next appointment will be at the local hospital with an eye specialist.

Stable treated proliferative retinopathy R3SM0

The retina shows evidence of PRP and stable treated proliferative retinopathy. The next appointment will be in a surveillance clinic for closer monitoring. Closer monitoring screening for stable treated proliferative retinopathy is offered at either 6, 9 or 12 month intervals with multi-field photography. We will take about 8 photographs of each eye so that we can see more of the retina. The appointment is still in the community with the same screening staff, but it might not be at the local GP surgery.

Unassessable

The retinal photographs are not clear enough for us to see enough of the retina. The next appointment will be in a slit lamp clinic with an SLB examiner. The appointment is still in the community with a qualified SLB examiner, but it might not be at the local GP surgery.

Non-diabetic retinopathy eye conditions

The retina shows evidence of another eye condition which needs either urgent or routine assessment or treatment by an eye specialist. A direct referral will be made at the local hospital with an eye specialist. The person with diabetes will also continue to be screened for DR appropriately in NYDESP.

Screening does not look for other eye conditions and we advise people with diabetes to continue to visit their optician regularly for an eye examination.