R2 Or Not? October 2018

Total responses: 40

Image 1

Overall Result:

R2: 18%

Not R2: 82%

Broken down by grader level:

Trainee Graders (8)

• R2: 25%
• Not R2: 75%

Qualified Graders (18)

• R2: 17%
• Not R2: 83%

ROG/L3 Graders (14)

• R2: 14%
• Not R2: 86%

Comments from those who said R2:

• ? A small area of IRMA near the macula? I'm uncertain on this one - I'd probably have missed it.

Comments from those who said NOT R2:

• Background DR - red free images enhances NFL but no R2 features. Easier to grade in colour for this image
• No definite IRMA visible. Just couple of haems.
• No way is this R2. What justifies this grade to make it R2? There is a small haemorrhage superior to disc and if that has been put down as IRMA then whoever graded it originally needs to be retrained!
• If just going by that image then there is nothing on to suggest R2. A few small bleeds. I would grade that image R1

Image 2

Overall Result:

R2: 23%

Not R2: 77%

Broken down by grader level:

Trainee Graders (8)

• R2: 25%
• Not R2: 75%

Qualified Graders (18)

• R2: 33%
• Not R2: 67%

ROG/L3 Graders (14)

• R2: 7%
• Not R2: 93%

Comments from those who said R2:

None

Comments from those who said NOT R2:

• As per image 1 - background changes. Better to grade in colour
• No definite IRMA visible. Just couple of haems.
• Not enough activity to justify this to be R2 on one single image.
• Same comments as number 1. If just going by that image then there is nothing on to suggest R2.

Image 3

Overall Result:

R2: 93%

Not R2: 7%

Broken down by grader level:

Trainee Graders (8)

• R2: 88%
• Not R2: 12%

Qualified Graders (18)

• R2: 94%
• Not R2: 6%

ROG/L3 Graders (14)

• R2: 93%
• Not R2: 7%

Comments from those who said R2:

• Possible even R3A ?NVE
• Multiple dot/blot haems. Small area IRMA
• I've said that it is R2 but I'm on the fence with this. There is maculopathy so would be referred anyway.
• Deep blot haemorrhages and more activity.
• R2M1

Comments from those who said NOT R2:

• 13 week referrable due to M1 anyway, and ?IRMA inferior to the disc but no true R2 features. Not enough MBH either