R2 or Not? June 2018

Total: 40 responses

Image 1

Overall Result:

R2: 90%

Not R2: 10%

Broken down by grader level:

Trainee Graders (6)

• R2: 83%  
• Not R2 17%

Qualified Graders (27)

• R2: 89%  
• Not R2: 11%

ROG/L3 Graders (7)

• R2: 100%
• Not R2 0%  

Comments from those who said R2:

• visible IRMA both inferior and superior to macular, as well as presence of CWS
• It would be better if one could enhance the image, there is a suspicious vessel formation in superior quad.
• Image sets 1 and 2 appear to be the same eye.
• Looks like irma type vessels supero-temporal towards edge of image
• Although no really any blots seen, there looks like there might be a fair amount of IRMA, wouldn't be happy to leave for 12 months, so would grade as R2.
• borderline evident IRMA
• It would be better if one could enhance the image, there is a suspicious vessel formation in superior quad.
• R2M1

Comments from those who said NOT R2:

• None recorded

Image 2

Overall Result:

R2: 85%

Not R2: 15%

Broken down by grader level:

Trainee Graders (6)

• R2: 100%  
• Not R2 0%

Qualified Graders (27)

• R2 89%
• Not R2: 11%

ROG/L3 Graders (7)

• R2: 57%
• Not R2 43%

Comments from those who said R2:

• The nasal view to Image 1, shows more defined IRMA nasally - however, would be prudent to look for NVE as it seems to be far more defined, cautious with this one and possible R3 (ROG grader)
• As with images one there are hypertensive changes but not having seen previous images I would feel that R2 is more appropriate

Comments from those who said NOT R2:

• Borderline evident IRMA...without tools to enhance or redfree the image its hard to confirm this decision 100%. Therefore its safe to grade it up
• Early vessel changes not quite true Irma (ROG grader)
• Nasal Photos of Image 1? Still R2

Image 3

Overall Result:

R2: 58%

Not R2: 42%

Broken down by grader level:

Trainee Graders (6)

• R2: 50%
• Not R2: 50%

Qualified Graders (27)

• R2: 67%
• Not R2: 33%  

ROG/L3 Graders (7)

• R2: 28%
• Not R2 72%

Comments from those who said R2:

• Based on red-free image, would ?the vessel adjacent to the CWS as early IRMA. Good case for DS clinic, to check if it changes. (ROG grader)
• Small reduplication 5 o'clock to disc (ROG grader)
• Evident of IRMA around or near cotton wool spots

Comments from those who said NOT R2:

• images have an isolated IRMA, in such case I would recall in 3/12 for observation with the comments that the graded is close to R2
• Looks more like reworking vessel around CWS