The COMS Grading Scheme: Graded Features

Neovascularization of the disc

Neovascularization of the disc is characterized by the development of variable caliber vessels anterior to the optic nerve or retina.  They could cross over normal retinal vessels, because they grow anterior to the plane on the retina.  These vessels leak profusely on angiogram.  Neovascularization over the nerve or within 1500 microns of the edge of the optic nerve (anything within the peripapillary field), is considered neovascularization of the disc. 

Severity

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None: not present

Mild:  less than 1/5 disc area (standard photograph 1 with angiogram)

Moderate: more than 1/5 disc area, but less than 1¼ disc areas (standard photograph 2 with angiogram)

Severe: more than 1¼ disc areas

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