Diabetic retinopathy. Control of systemic factors preserves vision.

Diabetic retinopathy, a retinal microangiopathy, is the leading cause of blindness for persons aged 20 to 65 years in the United States. Routine screening and early treatment are cost-effective and have been shown to help preserve sight. Primary care physicians play a key role in treatment of systemic factors that lead to poor outcomes and referral to an ophthalmologist or a retinal specialist for screening and local treatment. This article, the first of two on retinal vascular disease, provides a review of nonproliferative and proliferative diabetic retinopathy. The second article, which will appear in an upcoming issue of POSTGRADUATE MEDICINE, discusses retinal vascular disease in hypertension.