Heavy Particles, the Bragg Curve and Suppression of Pituitary Function in Diabetic Retinopathy

Abstract

During the past six years heavy particles such as protons and alpha particles have been used to achieve partial or complete hypophysectomy in an attempt to slow down the progressive, severe diabetic retinopathy in seventy-one patients. Pituitary suppression was indicated by fall in the insulin requirements and target-organ outputs of these patients. Sixty-one patients had been followed long enough for re-evaluation; the retinopathy had stabilized in thirty-eight of these, and it was further noted that fourteen of these thirty-eight patients also showed improvement in visual acuity. The objective improvements observed in the appearance of the eye grounds were decreases in frequency of hemorrhages and microaneurysms and a decrease in neovascularization and exudates. Eleven patients had died: six with uremia, three of acute myocardial infarction, one of auricular fibrillation, and one of cardiovascular collapse. The findings indicate that retinopathy can be favorably influenced by suppression or ablation of pituitary function, but it is felt that patients with advanced cardiovascular and renal complications are not desirable candidates.