Asymptomatic development of proliferative retinopathy in insulin-dependent diabetes.

Ten insulin-dependent diabetic subjects under the age of 44 years with duration of diabetes from 10 to 30 years were studied. All demonstrated a pattern of rapid development of retinovascular proliferation with few or late symptoms. Retinal changes which threatened or ultimately destroyed vision developed while good visual acuity was maintained. Fifty percent of these had advanced beyond the stage at which treatment is most beneficial when first examined. The "silent" progression of this binding disorder permits it to escape detection and therapeutic intervention prior to a stage of advanced damage. Early and regular ophthalmic assessment of the young, insulin-dependent diabetic is essential for the prevention of blindness.