R2 or Not? January 2018

Total: 54 responses

Image 1

Overall Result:

R2: 72% 

Not R2: 28% 

Broken down by grader level:

Trainee Graders (10)

• R2: 70%  
• Not R2 30%

Qualified Graders (32)

• R2: 78%
• Not R2: 22%

ROG/L3 Graders (12)

• R2: 58%
• Not R2 42%

Comments from those who said R2:

• Poss IRMA
• Image has MBH with CWS and it looks like a small amount of IRMA 6 o'clock for the fovea
• just about qualifies as multiple blot Hms
• MBH
• Multiple blots haems > 8 in total and appear in all quadrants seen. Possible IRMA. CWS's assoc with haems
• I thought there was IRMA patch inferior to the optic disc.

Comments from those who said NOT R2:

• Small area of new vessels
• Not enough for MBH? Without manipulation tool, can't see definite IRMA.
• unable to clearly see IRMA or mutliple BH

Image 2

Overall Result:

R2: 63% 

Not R2: 37% 

Broken down by grader level:

Trainee Graders (10)

• R2: 70%
• Not R2: 30%

Qualified Graders (32)

• R2 66%  
• Not R2: 34%

ROG/L3 Graders (12)

• R2: 50%
• Not R2 50%

Comments from those who said R2:

• Undoubtably R2, take care to look for NVE
• IMe 2 and Image 3 are the same eye, so I think there are enough haems, and possible exudate.
• appear to be clear indication of IRMA
• ? IRMA temp and superior to OD
• Venous reduplication along IT arcade

Comments from those who said NOT R2:

• Suspicious vessel/haemorrhage - R3
• Suspect NVE as well as IRMA so would grade as R3

Image 3

Overall Result:

R2: 54% 

Not R2: 46% 

Broken down by grader level:

Trainee Graders (10)

• R2: 60%
• Not R2: 40%

Qualified Graders (32)

• R2: 50%
• Not R2: 50%

ROG/L3 Graders (12)

• R2: 58%
• Not R2 42%

Comments from those who said R2:

• IRMA at 5 o'c position, 2DD away from the disc
• this is possibly just R2, would grade it as such to be safe
• same eye as image 2. Enough blot Haems on disc centred to be MBH
• signs of IRMA 12 o clock from the disc
• MBH
• On MBH, borderline and nasal shot only

Comments from those who said NOT R2:

• Hard to see - suspicious vessels - R3
• I think this is the same retina as image 2 so on that basis and from what is seen R3 for ?NVE.
• No definite IRMA and not quite enough blot haems for MBH (just <8 haems)
• Looks R2 except poss NVE superior arcade - hard to tell though for sure and only small low risk flat area if so

• possible 8 haemhorrage but no definite irma