[Stereotaxic pituitary implantation of radio-gold in the treatment of severe diabetic retinopathy. Long term results (author's transl)].
The ophtalmic, diabetic and hormonal outcome in 16 patients treated identically for diabetic ophtalmopathy with pituitary radio-gold implants were assessed 1, 2, 5 and 10 years afterwards. Four patients (25%) died in the first 6 years, 3 of them of severe renal insufficiency which developed after pituitary implantation. Of these remaining alive at each assessment visual acuity was either stable or improved in 78%, 58%, 64% and 42% respectively, but at very low levels since at 10 years acuity was 1/10 or less in half the population. Four patients became blind, the remaining eight had a severe proliferative retinopathy with exsudates and haemorrhages but retained useful vision. Haemorrhage and new vessel formation continued to develop with the years following implantation in all patients who at the time had one on either lesion. Cataracts were removed in 6 patients, 3 and 7 years after implantation. The mean insulin requirements of the group fall from 55 to 31 units daily. The fall in growth hormone concentration, occuring in only 45% of cases, does not account for all the improvements observed. Several hormonal deficiencies developed: 2 cases of adrenal insufficiency, 3 of hypothyroïdism and 6 of hypogonadal impotence.
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods; D003930:Diabetic Retinopathy / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006050:Gold Radioisotopes / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland; D011183:Postoperative Complications; D013238:Stereotaxic Techniques
D006050:Gold Radioisotopes
Rétinopathies diabétiques sévères traitées par implantation stéréotaxique intra-hypophysaire d' or radio-actif. Résultats à long terme chez 16 malades.