Tratamiento con octreótide de la retinopatía diabética avanzada

Résumé

Aim: Determine the effectiveity of the treatment with Octreotide in the proliferative advanced diabetic retinopathy (PADR). Method: After informed consent to the patients, assay treatment with Octreotide in 2 women 28 and 29 years with Diabetes Mellitus type 1, both of 20 years of evolution, with bad metabolic chronic control (HbA1c of 9-15% and 9-10%) and serious systemic repercussions (PADR with photocoagulation, established nephropathy diabetic and incipient respectively, diabetic dermopathy, sensitive peripheral neuropathy ). They presented hemovitreous severe precising vitrectomy and 3 surgicals procedures in a case by bleding successive. Octreotide would act in PADR inhibitting the secretion of GH and the factors of growth angiogenyc local factors. Was utilized to dose between 75 and 150 mcg/24h. Results: In a case exists a very favorable response with back evolution kept over 18 monthes with decrease of new rebledings and marked recuperation of the visual sharpness. An eye remains without hemorrhage with proliferation epirretiniana fibrous blocked. The other with hemovitreous but without ecografics signes of traction retinal detachement nor proliferation. In the other case was observed in 6 monthes a marked control of the proliferation and of to exude. The ecografía abdominal was normal in both. Produced a progressive decrease of the dose of insulin with episodes of hypoglycemia severe in a case. That presented, furthermore, improved marked of the nefropathy established. Conclusions: Octreotide could represent a therapeutic alternative in patients with PADR