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November 1962

Therapeutic Hypopituitarism for Diabetic Retinopathy

Arch Ophthalmol. 1962;68(5):579-580. doi:10.1001/archopht.1962.00960030583001

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That the pituitary gland could be involved in diabetes was first demonstrated in 1931 by Houssay who found that removal of the pituitary partially alleviated experimental diabetes in animals. The therapeutic possibilities of pituitary ablation in human beings were not explored, however, until the early 1950's when Luft, Olivecrona, and Sjögren reported hypophysectomy in 20 juvenile diabetics with retinopathy and when Poulson incidentally observed amelioration of diabetic retinopathy in a young woman who suffered postpartum necrosis of the pituitary (Sheehan's disease).

During the past 10 years hypopituitarism has been neurosurgically induced for diabetic retinopathy by means of hypophysectomy, hypophyseal stalk section, and by implantation of yttrium90 in the pituitary fossa; the pituitary has been approached by the transfrontal, frontotemporal, and trans-sphenoidal routes. The reports have varied from enthusiastic endorsement, including appeals for earlier surgery, to blanket renunciation. The average ophthalmologist, anxious to do right by his diabetic patient threatened

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