Diabetic Retinopathy and the Pituitary

Treatment of Diabetic Retinopathy With Estrogens

“…Moreover, the incidence of diabetic retinopathy in patients with pituitary tumors who become diabetic does not appear to be increased. In one series of 66 patients with pituitary tumors, 30 had associated diabetes; only 2 of the 30 diabetics were found to have diabetic retinopathy (45). (Inasmuch as the majority of these patients who manifest pituitary diabetes tend to do so within the the first six years after clinical onset of the pituitary tumor, the infrequency of diabetic retinopathy in this situation may be related to a time factor.)…”

“…In advanced diabetic retinopathy, there is a free and perivascular deposition of cholesterol crystals and lipid (7, 47 b ). The stabilization of such relationships may result from the changes in the levels of blood sugar and serum lipids brought about by the use of estrogens, heparin or other agents (45, 48). This offers another explanation for their salutary effect in diabetic retinopathy, as discussed in the next section.…”

Diabetic Retinopathy in Acromegaly

“…When the cases of severe retinopathy in second ary diabetes mellitus are studied critically, many problems are raised. Ranke's [1959] case showed vitreous and retinal hem orrhage and proliferative changes. This patient had a pituitary tumor and, as mentioned by the author, it is possible that the changes were due to choked disc.…”

“…In addition, there seem to be very few reports in the literature on the occurrence of diabetic retinopathy in diabetic patients with either acromegaly or Cushing's syndrome. Ranke [1959] noted that the frequency of diabetic retinopathy in acromegalic diabetes was lower than in pri mary diabetes. According to Coggeshall and Root [1940), 26 (17%) of 153 patients with acromegaly had diabetes mellitus, but no diabetic retinopathy.…”

“…However, re ports have dealt only with the frequency of retinopathy in acromegalic patients [Coggesliall and Root, 1940;McCullaglt and Alivisatos, 1954;Ranke, 1959;Ricketts, 1948], In the present study, diabetic retinopathy in acromegaly is discussed in relation to the clinical and laboratory data of acromegalic patients.…”