Recent developments in the understanding and management of diabetic retinopathy.

The natural history of diabetic retinopathy, one of the leading causes of visual impairment in the United States, is well described; its pathogenesis, however, is poorly understood. The Diabetic Retinopathy Study and the Early Treatment of Diabetic Retinopathy Study have demonstrated that timely intervention with photocoagulation prevents visual loss. However, recent studies demonstrate that many diabetic patients are not being referred to ophthalmologists for timely treatment. Suggested management and referral strategies are presented in this article.