Which findings are indicative of moderate NPDR?

In the context of diabetic retinopathy, moderate Non-Proliferative Diabetic Retinopathy (NPDR) is characterized by specific retinal changes that signal worsening of the disease while still not showing signs of neovascularization, which is associated with proliferative diabetic retinopathy.

The presence of multiple hard exudates along with more than three blot hemorrhages indicates the worsening of the condition because these findings suggest leakage from retinal blood vessels and increased vascular permeability, which are key features of moderate NPDR. Hard exudates represent lipid deposits resulting from chronic retinal edema, and blot hemorrhages are indicative of deeper retinal bleeds, both of which are relevant in assessing the severity of retinopathy.

Other findings like more than 10 cotton wool spots could suggest a more severe condition, and the presence of retinal neovascularization is a hallmark of proliferative diabetic retinopathy rather than moderate NPDR. The presence of only microaneurysms indicates early-stage retinopathy, not moderate, as this stage typically shows additional signs of vascular changes reflecting more significant pathology. Hence, the combination of multiple hard exudates and blot hemorrhages is the most accurate representation of moderate NPDR.