Diabetic retinopathy. Background, classification, pathophysiology.

Diabetic retinopathy is the leading cause of legal blindness in the working adult population of the United States. The longer the duration of diabetes, the greater the likelihood retinopathy will develop. The proper classification of retinopathy is critical to the appropriate choice of therapeutic intervention and to the frequency of follow-up office visits. Monitoring of the patient must be a cooperative, team approach and requires early referral to an ophthalmologist experienced in the care of diabetics. The mainstay of current treatment is prevention through improved glucose control, early detection and, when necessary, intervention with timely laser photocoagulation and/or vitrectomy surgery. Based upon increased knowledge of the pathophysiology of diabetic retinopathy, the future may hold the ability to treat it with biological interventions at an earlier point in the course of the disease.