Hypophysectomy for Diabetic Retinopathy

The Diabetic Eye

“…The impetus for pituitary ablation came from the observation by Poulsen (1953) of remission and eventual clearing of retinopathy in a woman who suffered from postpartum necrosis of the pituitary, with clinical Simmonds disease and increased sensitivity to insulin. Ablation can be produced by hypophysectomy (Luft, Olivecrona, Ikkos, Kornerup, and Ljunggren, 1955;Kinsell, 1957;Schimek, 1956;Javid, Gordon and Erickson, 1958; Vannas, Hernberg and Bjorkesten, 1959) performed transcranially or trans-sphenoidally; alternatively the pituitary stalk may be divided and a diaphragm inserted to prevent healing of the portal venous system (Contreras and others, 1962). Irradiation with a neutron beam (Sangalli, 1961), and implantation of radioactive Yttrium-90 seeds through a cannula passed across the top of the nasal cavity under radiographic control (Fraser and Joplin, 1961) are alternative methods.…”

Ophthalmological Observations in Hypophyseal Stalk Section

“…4. The accumulated observations suggest that the common denominator of the bene¬ ficial effect of stalk section is improvement in retinal and uveal blood flow.…”

Neuro-Ophthalmology

“…and Wadensten.172 The KayserFlei scher rings found in two patients with hepatolenticular degeneration were examined and observations were made in relation to the pathogenesis and clinical appearance by Uzman and Jakus.173 H vpophysectomy is being performed in two conditions affecting the eyes. Tt has been done for the treatment of malignant edematous exophthalmos as described by Voisin, Albeaux-Fernet, Guiot, and Haye.174 Hypophysectomy has been done with the hope of restoring vision in severe diabetic retinopathy with retinal and vitreous hemor¬ rhages as described by Schimek,175 who re¬ ports five cases treated, with cessation of visual loss from ocular hemorrhage.…”