Diabetic retinopathy, present and future. Conclusion of diabetic retinopathy symposium

The preceding reports of the Diabetic Retinopathy Symposium are reviewed. Diabetic retinopathy progresses with the duration of disease and often results in proliferative retinopathy in the juvenile onset patient and macular edema in the older onset patient. Periodic ophthalmoscopic examinations are essential in detecting the progression of retinopathy and development of disease characteristics which indicate a need for treatment. Laboratory and clinical experience stress the importance of rigid glucose control in preventing diabetic retinopathy. Ischemia of the midperipheral retina stimulates the development of high risk factors for which panretinal photocoagulation is indicated despite side effects such as decreased dark adaptation. Pars plana vitrectomy results in substantial visual improvement in eyes with nonclearing vitreous hemorrhage and/or traction retinal detachments involving the macula. Future advances in our knowledge of diabetic retinopathy should come from the National Eye Institute's Collaborative Diabetic Retinopathy Vitrectomy Study and Early Treatment Diabetic Retinopathy Study, and the analysis of vasoformative factors.