Summary
Samenvatting Gradatiesystemen D en P
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In dit document de gradatiesystemen voor het tentamen van D en P.
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GradatiesystemenHypertensieve retinopathie
Graad 1 Vasoconstrictie (beschermende
functie)
Graad 2 Veranderingen van de
vaatwanden, bredere arteriele
lichtreflex (copper wire reflex),
verandering AV kruisingen
Graad 3 Graad 2 + lekkende bloedvaten
(vlamvormige bloedingen,
exsudaten), cotton wool spots
Graad 4 Graad 3 + oedeem van de papil en
een stervormig patroon van
exsudaten (macula star)
, Diabetische retinopathie
Graad R1 Milde achtergrond retinopathie,
MA en/of dot-blot bloedingen
(max 10)
Interval 1 jaar
Graad R2 Pre-proliferatief, meerdere dot-
blot bloedingen en/of IRMA en/of
venous beading en/of reduplicatie
Verwijzing
Graad R3 Proliferatief, nieuwe vaten worden
gevormd, pre-retinale fibrose,
glasvocht of pre-retinale
bloedingen met/zonder loslating
door tractie
Snelle verwijzing
Graad M1 Gaat gepaard met R1/2/3
Aanwezigheid van exsudaten/MA/
bloeding binnen 1 DD van het
centrum van de fovea
Milde NPDR 1-20 MA, 1-20 dot blot bloedingen in INL/OPL
Matige NPDR MA/dot blot bloedingen in meer dan 1 kwadrant of meer cotton wool
spots. Venous beading of IRMA
Ernstige 4-2-1 regel, MA/bloedingen in 4 kwadranten, venous beading in 2 of
NPDR meer kwadranten en IRMA’s in 1 of meer kwadranten
Zeer ernstige Meer dan 2 criteria’s voor ernstige NPDR
NPDR
Niet high-risk NVE <1/2 DD OF NVP <1/4 deel van de papil
PDRP
High-risk NVP 1/3-1/4 van de papil, of NVE en glasvochtbloeding (GVB) of pre-
PDRP retinale bloeding
Ernstige Retina gedeeltelijk onbeoordeel-baar door GVB of Abl ter plaatse van de
PDRP fovea
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