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  • Title: [Trial treatment of diabetic retinopathy by inhibition of pituitary somatotropin secretion with MAP].
    Author: Bruni B, Bruni-Bocher K, Della Valle A, Gamba S.
    Journal: Minerva Med; 1975 Mar 21; 66(21):1001-23. PubMed ID: 1124148.
    Abstract:
    The recent literature relating to the pathogenesis of diabetic retinopathy, with or without nephropaty, is critically reviewed. Particular attention is given to the Growth Hormone (GH) hypothesis. The various procedures of hypophysectomy are discussed, including the possible ways of suppressing growth hormone production or overproduction by drugs, and expecially by medroxyprogesterone acetate (MAP). Personal results obtained with long-term administration of MAP in deposit form on alternate days in 10 patients with advanced retinopathy are described. An icostant and rely significant suppression of the GH response to insulin-induced hypoglicemia was noted in 6 cases, showing that a complete pituitary inactivation had been achieved. Therefore, the modifications observed in the fundus picture (studied with retinal photographs according to the Hammersmith Hospital Standards) seem to have no relationship with such a condition. The features involved were Microaneurysms and Haemorrhages (HAEMS) and Exudates (EX);New Vessels (NV) and Retinitis Proliferans (RP) were unaffected. Subjective improvement is visual acuity appeared to be more frequent, with various possible explanations. MAP was without appreciable effect on the clinical and metabolic course of the diabetes, or on renal function in cases of concomitant nephropathy. In the light of these preliminary results, further investigations might seem to be justified. The recent literature relating to the pathogenesis of diabetic retinopathy, with or without nephropathy, is critically reviewed. Particular attention is given to the (GH) growth hormone hypothesis. The various procedures of hypophysectomy are discussed including the possible ways of suppressing GH production or overproduction by drugs, especially with (MAP) medroxyprogesterone acetate. Personal results obtained with long-term administration of MAP in depot form on alternate days in 10 patients with advanced retinopathy are described. An inconstant and barely significant suppression of the GH response to insulin-induced hypoglycemia was noted in 6 cases showing that a complete pituitary inactivation had not been achieved. Therefore, the modifications observed in the fundus picture seem to have no relationship with such a condition. The features involved were Microaneurysms and Hemorrhages and Exudates. New vessels and retinitis proliterans were unaffected. Subjective improvement in visual acuity appeared to be more frequent with various possible explanations. MAP was without appreciable effect on the clinical and metabolic course of the diabetes or on renal function in cases of concomitant nephropathy. In light of these preliminary results, further investigation seems to be justified. (author's modified) (summary in ENG).
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