Octreotide reduces vitreous hemorrhage and loss of visual acuity risk in patients with high-risk proliferative diabetic retinopathy

Objective: Growth hormone and insulin-like growth factor- have been implica ted as strong promoters of proliferative diabetic retinopathy. We studied r eduction of bleeding and preservation of visual acuity by treatment with th e long-acting somatostatin analogue, octreotide, in diabetic patients at an advanced stage of proliferative diabetic retinopathy. Research Design and Methods: Randomized trial in a University hospital setting. Reading ophthal mologists were masked for octreotide use, diabetologists were aware of that treatment. Nine patients received 100 mug tid octreotide (verum) subcutane ously for a maximum of 36 months. Nine diabetics served as controls, no pla cebo treatment was used. Episodes of vitreous hemorrhages were counted, mea surement of visual acuity, estimation of neovascularization by stereoscopic fundus photography and fluorescein angiography were carried out. Results: After 3 years of treatment, the incidence of vitreous hemorrhages and the n eed for vitreoretinal surgery was significantly lower (log rank test p = 0. 002) in the octreotide-treated patients. Visual acuity was preserved and si gnificantly better in the octreotide treated group compared to controls (p= 0.05). Conclusions: In diabetics with high-risk proliferative retinopathy a fter full scatter laser coagulation, octreotide reduced the number of vitre ous hemorrhages, preserving visual acuity.