Reversal of diabetic retinopathy by continuous subcutaneous insulin infusion: a case report

We report the case history of a 20-year-old diabetic girl with long-standing poorly controlled disease who presented with severe retinopathic features and who was treated with continuous subcutaneous insulin infusion (CSII). When first seen she had macular oedema and a visual acuity of 6/18 in her only eye, together with multiple blot haemorrhages and intraretinal microvascular abnormalities. Marked reversal of the retinal lesions occurred within 65 days of initiating SCII and after only 36 days of constant normoglycaemia. Subsequent good blood glucose control on conventional subcutaneous insulin injections has been achieved, and the retinopathy remains quiescent with a visual acuity of 6/5. We suggest that CSII may be a potentially useful method of arresting and reversing early diabetic retinopathy.