Prognosis of Proliferative Retinopathy in Juvenile Diabetics

Fifty-one mostly juvenile-onset diabetic patients with proliferative retinopathy without persistent proteinuria were observed for two to eighteen years (average six years) after proliferative retinopathy had been detected. At the end of five years 10 per cent had died, and about 50 per cent had become blind in both eyes (visual acuity 6/60 or less). Patients with localized, peripheral proliferations had better visual prognosis than patients with pre- or peripapillary proliferations. Hypercholesterolemia appeared to be a poor prognostic sign. It would appear on the basis of reported experience and the present investigation that a surgical procedure on the pituitary gland is a justified therapeutic attempt in juvenile diabetes with retinopathy consisting of either pre- or peripapillary or of widespread proliferations, provided that the patients have not already developed persistent proteinuria.