Fundoscopic appearance of severe NPDR
Fundoscopic appearance of severe NPDR
Fundoscopic appearance of moderately severe NPDR, bilateral OD/OS.

For a patient with nonproliferative diabetic retinopathy (NPDR), the overarching goal is to reduce disease severity and reduce progression to proliferative diabetic retinopathy (PDR). You can help drive patient outcomes through early detection, monitoring, and timely referral.1-3

A severity scale can help identify and standardize the clinical features of Diabetic Retinopathy (DR) at various stages and allow for early detection and timely intervention.1,4-6

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Severe NPDR Example



61 years of age

Left eye (OS)

Severe NPDR

Onset 2 years ago

No previous treatment

Clinical Findings

  • Diffuse intraretinal hemorrhages, hard exudates and microaneurysms, venous beading definite in 2 fields, intraretinal microvascular abnormalities medium in 2 fields

ETDRS-DRSS Score: 53

CRT: 246 μm

IOP: 16 mm Hg

ETDRS Letters: 79

Snellen Equivalent: 20/25

HbA1c: 10.3

BMI: 28

Medical History

Comorbidities: Type 2 diabetes, 14 years, treated with insulin and canagliflozin; previous ischemic stroke, currently treated with aspirin and clopidogrel

Familial: Father had type 2 diabetes and heart disease

Note: This is a representative case example that you may encounter in clinical practice.

BMI = body mass index; CRT = central retinal thickness; ETDRS–DRSS = Early Treatment Diabetic Retinopathy Study—Diabetic Retinopathy Severity Scale; HbA1c = glycated hemoglobin; IOP = intraocular pressure.



Timely Refer Appropriate Patients to a Retina Specialist Who Can Treat DR2,3

See More Important Safety Information and Indications
  • CONTRAINDICATIONS: EYLEA® (aflibercept) Injection is contraindicated in patients with ocular or periocular infections, active intraocular inflammation, or known hypersensitivity to aflibercept or to any of the excipients in EYLEA.
Important Safety Information and Indications INDICATIONS

EYLEA® (aflibercept) Injection 2 mg (0.05 mL) is indicated for the treatment of patients with Neovascular (Wet) Age-related Macular Degeneration (AMD), Macular Edema following Retinal Vein Occlusion (RVO), Diabetic Macular Edema (DME), and Diabetic Retinopathy (DR).

Please see the full Prescribing Information for EYLEA.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

The information provided in this site is intended only for healthcare professionals in the United States. The products discussed herein may have different product labeling in different countries.


  1. Early Treatment Diabetic Retinopathy Study Research Group. Fundus photographic risk factors for progression of diabetic retinopathy. ETDRS report number 12. Ophthalmology. 1991;98(5 suppl):823-833.
  2. Care of the Patient With Diabetes Mellitus: Quick Reference Guide. American Optometric Association website. http://bit.ly/2M22OUJ. Accessed January 14, 2020.
  3. Ferrucci S, Yeh B. Diabetic retinopathy by the numbers. Rev Optom. June 15, 2016. http://bit.ly/2KNNJ4E. Accessed January 14, 2020.
  4. Davis MD, Fisher MR, Gangnon RE, et al; for the Early Treatment Diabetic Retinopathy Study Research Group. Risk factors for high-risk proliferative diabetic retinopathy and severe visual loss: Early Treatment Diabetic Retinopathy Study report #18. Invest Ophthalmol Vis Sci. 1998;39(2):233-252.
  5. Staurenghi G, Feltgen N, Arnold JJ, et al. Impact of baseline Diabetic Retinopathy Severity Scale scores on visual outcomes in the VIVID-DME and VISTA-DME studies. Br J Ophthalmol. 2018;102(7):954-958.
  6. American Academy of Ophthalmology. Preferred Practice Pattern®: Diabetic Retinopathy. http://bit.ly/2SX3H2D. Accessed January 14, 2020.