Objective: Growth hormone and insulin-like growth factor-I have been implicated as strong promoters
of proliferative diabetic retinopathy. We studied reduction of bleeding and preservation
of visual acuity by treatment with the long-acting somatostatin analogue, octreotide,
in diabetic patients at an advanced stage of proliferative diabetic retinopathy. Research Design and Methods: Randomized trial in a University hospital setting. Reading ophthalmologists were
masked for octreotide use, diabetologists were aware of that treatment. Nine patients
received 100 μg tid octreotide (verum ) subcutaneously for a maximum of 36 months. Nine diabetics served as controls, no
placebo treatment was used. Episodes of vitreous hemorrhages were counted, measurement
of visual acuity, estimation of neovascularization by stereoscopic fundus photography
and fluorescein angiography were carried out. Results: After 3 years of treatment, the incidence of vitreous hemorrhages and the need for
vitreoretinal surgery was significantly lower (log rank test p = 0.002) in the octreotide-treated
patients. Visual acuity was preserved and significantly better in the octreotide treated
group compared to controls (p = 0.05). Conclusions: In diabetics with high-risk proliferative retinopathy after full scatter laser coagulation,
octreotide reduced the number of vitreous hemorrhages, preserving visual acuity.
Key words:
Diabetic Retinopathy - Growth Hormone - Insulin-Like Growth Factor I - Octreotide
Treatment
References
The epidemiology of eye disease. In: Pickup JC, Williams G (eds). Textbook of Diabetes. Oxford:; Blackwell Sciences,
1997 2nd ed: 44.1-44.9 Long-term visual outcome of diabetic patients treated with pan-retinal photocoagulation. In: Friedman EA, L’Esperance FA (eds). Diabetic-Retinal Syndrome. Boston:; Kluwer
Academic Publishers, 1998: 151-167
E-mail:bernhard.boehm@medizin.uni-ulm.de
