Clinical evaluation was done in cases with transsphenoidal hypophysectomy by embedding radonseed for the treatment of proliferative diabetic retinopathy, comparing pre and post-operative states.
Four cases with severe proliferative type retinopathy associated with vascularization at peripapillary area as well as at the main vessels were analyzed. Following results were obtained; 1) Disappearance of vascularization was noted in three cases, to whom the surgery was performed in the early stage of development of vascularization. The cessation of the vascularization appeared at the 3rd post-operative month in the earliest, and no progression was seen even in these cases with the period of five years after the operation. In a patient in whom preexisting vascularization was found at the first examination, a slight reduction of vascularization was noted after operation, however, a severe bleeding into vitreous body was observed at the 10th month after the operation.
2) Out of three cases mentioned above, one showed no response of HGH following arginine administration. There was low degree response to FSH as well as LH in LH-RH test. The remaining two cases showed slightly inhibited response of HGH to arginine infusion, and one case demonstrated an inhibitory effect of the TSH reaction to TRH test. In all of these three cases, pituitaryadrenal function was proved to be normal. In one case in whom the progression of diabetic retinopathy was seen, the response of HGH after arginine load was prominently elevated preoperatively, which was slightly inhibited after the operation.
The effect of hypophysectomy seemed not to depend upon the grade of hypophysectomy. It was effective even in case with slight hormonal suppression.
There findings indicate that in the cases with new-vessel formed in the area around the opticdisc or front of the optic disc, disappearance of neovascularization would occur if followed by the surgery in the early stage. Based on these findings, hypophysectomy appears to be an effective method if it is done in the cases with proliferative retinopathy associated with vascularization.