Hi Elaine Wooler I know at the last CRG meeting we mentioned a new framework / spreadsheet for content requests, but I can't seem to find where it is located (I may not be looking in the right places on the Confluence and if that's the case, my apologies!). If you can share that, we would be happy to fill it in accordingly for a set of new requests related to diabetic retinopathy phenotypes. In the meantime, I am sharing the proposed new concepts, their definitions, and peer-reviewed literature references, similar to what we did last time for a series of retina condition codes. I am also adding Cindy Cai to this thread as she is our retina domain expert and led the group that identified these. I inserted a link to a document but in case it's easier to read directly in the forum, I'm also copying directly into the thread here (although it seems like the numbering went awry after copying, but the concepts are all there):
Definition: is the natural formation of new blood vessels in the form of functional microvascular network, capable of perfusion of red blood cells, that form as collateral circulation in response to local poor perfusion or ischemia
Journal of opharmaceutical analysis - 10.1016/j.jpha.2023.05.002
Severe proliferative diabetic retinopathy
ICD-10-CM code: none
Definition: based on clinical impression, 1) Severe new vessels and severe fibrous proliferation 2) Severe new vessels and red vitreous hemorrhage 3) moderate new vessels, severe fibrous proliferations, and red vitreous hemorrhage
Definition: Any blood in the vitreous cavity; presence of extravasated blood within a space lined by posterior lens capsule anteriorly, internal limiting membrane posteriorly, and non-pigmented epithelium of ciliary body laterally
Definition: have been described in persons with and without hypertension and associated with clinical and subclinical manifestations of atherosclerosis and a broad group of risk factors for vascular disease; described as focal and generalized narrowing and arteriovenous nicking
Definition: some retinal thickening or hard exudates in the posterior pole, distant from the center of the macula
Literature review:
Ophthalmic and physiological optics - 10.1111/opo.13261
Ophthalmic and physiological optics - 10.1111/opo.13261
World journal of diabetes - 10.4239/wjd.v4.i6.290
Moderate diabetic macular edema
ICD-10-CM code: none
Definition: retinal thickening or hard exudates near the center of the macula but not involving the center
Literature review:
Ophthalmic and physiological optics - 10.1111/opo.13261
Ophthalmic and physiological optics - 10.1111/opo.13261
World journal of diabetes - 10.4239/wjd.v4.i6.290
Perifoveal capillary nonperfusion
ICD-10-CM code: none
Definition: is the nonperfusion of the retina circumscribing the parafovea and fovea; perifovea is a belt that covers a 10 degree radius around the fovea and is 1.5 mm wide
Ophthalmic and physiological optics - 10.1111/opo.13261
World journal of diabetes - 10.4239/wjd.v4.i6.290
Intraretinal hemorrhages
ICD-10-CM code: none
Definition: hemorrhage of the retina located in various layers from the internal limiting membrane to the outer nuclear layer which can cause hypofluorescent blockage
Journal of vitreoretinal diseases - 10.1177/24741264231163395
Romanian journal of ophthalmology - 10.22336/rjo.2023.51
Macular ischemia
ICD-10-CM code: none
Definition: is a common complication of diabetic retinopathy that is associated with damage in the vessels that supply blood to the retina and the enlargement of the foveal avascular zone
Literature review:
Ophthalmology and therapy - 10.1007/s40123-022-00546-3
It might be that you don't have the lefthand sidebar open. If you open that, the link is at the bottom of the page but also below for ease as not always easy to find these things.
3 Comments
Sally Baxter
Hi Elaine Wooler I know at the last CRG meeting we mentioned a new framework / spreadsheet for content requests, but I can't seem to find where it is located (I may not be looking in the right places on the Confluence and if that's the case, my apologies!). If you can share that, we would be happy to fill it in accordingly for a set of new requests related to diabetic retinopathy phenotypes. In the meantime, I am sharing the proposed new concepts, their definitions, and peer-reviewed literature references, similar to what we did last time for a series of retina condition codes. I am also adding Cindy Cai to this thread as she is our retina domain expert and led the group that identified these. I inserted a link to a document but in case it's easier to read directly in the forum, I'm also copying directly into the thread here (although it seems like the numbering went awry after copying, but the concepts are all there):
Diabetic Retinopathy Concepts
ICD-10-CM code: H35.05 (neovascularization, retina)
Definition: is the natural formation of new blood vessels in the form of functional microvascular network, capable of perfusion of red blood cells, that form as collateral circulation in response to local poor perfusion or ischemia
Literature review:
Investigative ophthalmology & visual science - 10.1167/iovs.65.1.22
Scientific reports - 10.1038/s41598-023-49964-8
Journal of opharmaceutical analysis - 10.1016/j.jpha.2023.05.002
ICD-10-CM code: none
Definition: based on clinical impression,
1) Severe new vessels and severe fibrous proliferation
2) Severe new vessels and red vitreous hemorrhage
3) moderate new vessels, severe fibrous proliferations, and red vitreous hemorrhage
Literature review:
Ophthalmic surgery, lasers and imaging retina –
https://doi.org/10.3928/1542-8877-20030701-01
Ophthalmology - 10.1016/s0161-6420(85)34002-2
Archives of ophthalmology - doi:10.1001/archopht.1985.01050110038020
ICD-10-CM code: H43.1 (hemorrhage, vitreous [humour] [intraocular])
Definition: Any blood in the vitreous cavity; presence of extravasated blood within a space lined by posterior lens capsule anteriorly, internal limiting membrane posteriorly, and non-pigmented epithelium of ciliary body laterally
Literature review:
Survey of Ophthalmology - https://doi.org/10.1016/S0039-6257(97)84041-6
Ophthalmology - https://doi.org/10.1016/S0161-6420(87)33528-6
Canadian journal of ophthalmology - https://doi.org/10.1016/j.jcjo.2017.09.027
ICD-10-CM code: none
Definition: have been described in persons with and without hypertension and associated with clinical and subclinical manifestations of atherosclerosis and a broad group of risk factors for vascular disease; described as focal and generalized narrowing and arteriovenous nicking
Literature review:
Retina - 10.1097/IAE.0000000000003959
Arteriosclerosis, thrombosis, and vascular biology -https://doi.org/10.1161/01.ATV.20.6.1644
Clinical & experimental ophthalmology - https://doi.org/10.1111/j.1442-9071.2008.01825.x
ICD-10-CM code: none
Definition: occurs when retina does not have the efficient tissue perfusion seen using fundus color or fundus fluorescein angiography
Literature review:
Bioimpacts - 10.15171/bi.2015.27
Ophthalmology - doi: 10.1016/j.ophtha.2019.06.022.
Scientific reports - 10.1038/s41598-020-71622-6.
ICD-10-CM code: none
Definition: some retinal thickening or hard exudates in the posterior pole, distant from the center of the macula
Literature review:
Ophthalmic and physiological optics - 10.1111/opo.13261
Ophthalmic and physiological optics - 10.1111/opo.13261
World journal of diabetes - 10.4239/wjd.v4.i6.290
ICD-10-CM code: none
Definition: retinal thickening or hard exudates near the center of the macula but not involving the center
Literature review:
Ophthalmic and physiological optics - 10.1111/opo.13261
Ophthalmic and physiological optics - 10.1111/opo.13261
World journal of diabetes - 10.4239/wjd.v4.i6.290
ICD-10-CM code: none
Definition: is the nonperfusion of the retina circumscribing the parafovea and fovea; perifovea is a belt that covers a 10 degree radius around the fovea and is 1.5 mm wide
Literature review:
International ophthalmology - doi.org/10.1007/s10792-023-02882-0
Annals of eye science – 10.21037/aes.2017.06.08
European journal of ophthalmology - https://doi.org/10.5301/ejo.5000948
ICD-10-CM code: none
Definition: retinal thickening or hard exudates involving the center of the macula
Literature review:
Ophthalmology - https://doi.org/10.1016/S0161-6420(03)00475-5
Ophthalmic and physiological optics - 10.1111/opo.13261
World journal of diabetes - 10.4239/wjd.v4.i6.290
ICD-10-CM code: none
Definition: hemorrhage of the retina located in various layers from the internal limiting membrane to the outer nuclear layer which can cause hypofluorescent blockage
Literature review:
Investigative ophthalmology & visual science - 10.1167/iovs.64.15.39
Journal of vitreoretinal diseases - 10.1177/24741264231163395
Romanian journal of ophthalmology - 10.22336/rjo.2023.51
ICD-10-CM code: none
Definition: is a common complication of diabetic retinopathy that is associated with damage in the vessels that supply blood to the retina and the enlargement of the foveal avascular zone
Literature review:
Ophthalmology and therapy - 10.1007/s40123-022-00546-3
Ophthalmologica, International journal of ophthalmology - 10.1159/000515406 Cureus - 10.7759/cureus.3064
ICD-10-CM code: none
Definition: is a yellow-white lesion in the superficial retina that usually occupies an area less than one fourth of that of the optic nerve
Literature review:
Computers in biology and medicine - 10.1016/j.compbiomed.2023.107854
Journal of digital imaging - 10.1007/s10278-015-9793-5
British medical journal case reports - https://doi.org/10.1136/bcr-2023-255723
Elaine Wooler
Hi Sally Baxter and Cindy Cai
It might be that you don't have the lefthand sidebar open. If you open that, the link is at the bottom of the page but also below for ease as not always easy to find these things.
SNOMED CT Content requests
Best wishes
Elaine
Sally Baxter
Thank you Elaine Wooler - I totally missed that link at the bottom of the sidebar! thank you