Severe adolescent-onset proliferative diabetic retinopathy: the effect of pituitary ablation

Proliferative diabetic retinopathy (PDR) is uncommon in patients younger than the age of 20 and has been rarely reported. Since 1969, 14 adolescents with severe PDR have been seen, the youngest of whom was 16 years old and the oldest, 19 years old. The shortest duration of diabetes mellitus prior to diagnosis of PDR was eight years. Ten patients had a positive family history of diabetes. Thirteen patients had suboptimal metabolic control. Ten patients had some degree of azotemia, seven were hypertensive, and six had proteinuria. Ophthalmic findings included advanced neovascular and fibrous proliferation on initial classification, and rapid progression to blindness-which was most frequently secondary to traction retinal detachment. In a small retrospective study, pituitary ablation may have offered greater preservation of vision than that observed in untreated patients.