Despite significant advances in therapeutic strategies, diabetic retinopathy remains a leading cause of preventable vision loss among working-aged people in many developed countries.1 In the United States, about 1 in 4 diabetic patients has signs of retinopathy and 1 in 20 has vision-threatening retinopathy.2 Because early treatment is associated with better outcomes, clinicians routinely try to estimate a patient's risk of visual morbidity from diabetic retinopathy based on traditional risk factors (eg, diabetes duration, glycemic control, and blood pressure control) and retinopathy severity.