RxMx grading system for diabetic retinopathy

The images of retinas taken at screening are graded according to national protocol using the RxMx grading system definitions:

R0 = No retinopathy

R1 = Background retinopathy

R2 = Pre-proliferative retinopathy

R3A = Active proliferative retinopathy

R3S = Stable proliferative retinopathy

M0 = No maculopathy

M1 = Maculopathy

A lead clinician in each local screening service determines the final grade and outcome for the patient. The patient is then either returned to annual screening, referred to a digital surveillance clinic for more frequent monitoring or referred to hospital eye services.

Referral from screening to digital surveillance clinic

• Possible results:
  • R2, M1, R3S
• Follow-up:
  • Screened in surveillance clinic every three, six or 12 months depending on progression of disease.

Referral from screening to hospital eye services

• Possible results:
  • R3A, R2, M1
• Follow-up:
  • Referred to hospital for diagnosis, possible follow-up tests and treatment. Returned to screening or surveillance after discharge.

Reference:

1. NHS (2016). NHS Diabetic Eye Screening Programme – Information for Health Professionals. Available from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/505587/DES_07_GP_information_sheet_March_2016.pdf  (Accessed on 15 Aug 2022)