Some  of the many scientists who advanced the knowledge of diabetes.
The race for the discovery of a pancreatic extract that can cure diabetes was fierce. Nicolas Paulesco of Romania nearly succeeded in winning the crown. He prepared a pancreatic extract called pancreatin which he showed to reduce blood and urine glucose in animals but had severe hypoglycaemic effect. It was never used on human.
Bernado Houssay was an Argentinean physiologist who showed that pituitary ablation in dog normalized its blood glucose. He won a Nobel Prize for this finding. Before the advent of laser, pituitary ablation was used in selected patients to treat proliferative diabetic retinopathy.
Carl and Gerti Cori (husband and wife) won a Nobel Prize for their work on Cori cycle: the conversion of glucose into glycogen in liver in the presence of insulin. 
Dorothy Hodgkin was an Oxford researcher who won a Nobel Prize for her work on crystallography. She was the first scientist to decipher the 3-dimensional structure of the insulin molecule.
Rosalyn Sussman Yalow (1921-) won a Nobel Prize for her work on radio-
immunoassay. The technique is used to measure the amount of insulin circulating in the body.
Section 7 Management of New Vessels Elsewhere 
(for a larger view of the retina please click the picture)
7.1 Definition
NVE are defined as any abnormal collection of leaking vessels occurring on 
retina more than one disc diameter from the rim of the optic disc. 
They normally occur in the post-equatorial retina with a predilection for the 
vascular arcades. However, NVE in the nasal retina also occur and may be 
easily missed. Untreated NVE in particular are associated with tractional 
retinal detachment, hence the importance of their early detection and 
7.2 Treatment of NVE
Treatment is the same as for NVD ie by pan-retinal photocoagulation (PRP). 
Areas of retinal ischaemia as determined by fluorescein angiography should be 
preferentially treated and a more peripheral application of laser burns helps to 
preserve more of the visual field, while being equally effective. 
7.2.1 Early NVE
Early NVE responds to a basic PRP as NVD (see above (Figs 23a and b)
7.2.2 Progressive NVE
NVE may present as relatively advanced abnormal vascular structures 
(Figure 11) which require a full PRP which particular attention being paid 
to the areas of ischaemic retina in the proximity of the NVE (Figure 24a and b).
Fig 24 NVE treated with PRP (a), resolution of NVE (b).
7.2.3 Florid NVE
NVE may develop rapidly and in more than one site (Figure 12 and 23). 
This condition required aggressive management as for florid NVD, attention 
being paid to the regions of ischaemic retina.
7.2.4 Non-responding NVE
On occasion, NVE may not fully respond to PRP and persist as foci of leaking 
vessels. Attempts should be made to close down such vessels with the 
application of further laser, particularly around the vicinities of the NVE, in a 
series of short focal applications. The active vessels should be monitored 
every 2-3 weeks.
7.2.5 NVE with gliosis
NVE particularly on the vascular arcades may form firm vitreoretinal 
adhesions which promote the development of gliosis (Figure 25). Such 
lesions may act as the focus for traction on the retina which, if treated 
too aggressively with laser therapy, may develop retinal holes and lead to 
rhegmatogenous retinal detachment. Application of the laser some distance 
from the site of the gliotic NVE may help to induce regression of the new 
vessels. If the condition progresses however, for instance with vitreous 
hemorrhage or retinal detachment, vitrectomy may be required. 
Fig 25 Inferior arcade NVE with gliosis.
7.2.6 NVE with vitreous haemorrhage
NVE are frequently the cause of vitreous haemorrhage but the site of 
bleeding may be masked by the blood (Figure 18). NVE may be tracked 
to the point or tip of a subhyaloid haemorrhage. NVE with vitreous 
haemorrhage should be treated as for NVE with vitreous haemorrhage.
Epidemiology Clinical features Risk factors Screening
Lasers and lenses. NVD,, NVE.. Maculopathy
Vitrectomy. Cataract Special problems Counselling
References.. AAO guidelines Atlas of Retinopathy Contact lenses
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