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RxMx grading system for diabetic retinopathy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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)

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