Diabetic Papillopathy

Appen, Richard E.; Chandra, Suresh R.; Klein, Ronald D.; Myers, Franklin L.

doi:10.1016/s0002-9394(14)74854-8

Cited by 61 publications

(24 citation statements)

References 9 publications

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“…This condition is rarely simultaneously bilateral and does not apply to our patient. Like Appen et al [1], we suspect that some young patients with diabetes without clinical retinopathy sustain a local vasculopathy of the optic disc, resulting in transient leakage at the level of the optic nerve head via optic disc capillaries. In fact, using fluorescein angiography, we showed that leakage may precede the earliest detectable abnormalities of non-proliferative diabetic retinopathy [7,11].…”

Section: Discussionsupporting

confidence: 57%

Transient acute disc swelling associated with improved metabolic control in an adolescent with type-I diabetes: role of dexamethazone therapy

Dorchy¹,

Toussaint²,

Verougstraete³

et al. 1985

Eur J Pediatr

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Acute disc swelling in type-I diabetic patients is a distinct syndrome that may be distinguished clinically, particularly from papilloedema due to increased intracranial pressure. This paper reports the first detailed case of this rare condition in which disc swelling seems to be associated with rapid improvement of metabolic control. We suggest that the pathogenesis of disc swelling is related to a local breakdown of the blood retinal barrier at the level of the optic nerve, resulting in an intense leakage. Compression of the optic nerves secondary to this vasculopathy appeared to be reversed by administration of dexamethazone. It is suggested that in diabetic patients with long-standing poor metabolic control, rapid conversion to good metabolic control could have this result. However further information is necessary to substantiate this relationship.

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Section: Discussionsupporting

confidence: 57%

Transient acute disc swelling associated with improved metabolic control in an adolescent with type-I diabetes: role of dexamethazone therapy

Dorchy¹,

Toussaint²,

Verougstraete³

et al. 1985

Eur J Pediatr

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“…Diabetic papillopathy, characterised by transient edema of the optic disc, can appear in patients with long-standing Type I diabetes [46]. Its pathogenesis is not completely understood but its development is usually benign and specific treatment is not required.…”

Section: Diabetic Papillopathymentioning

confidence: 99%

Diabetic retinopathy

2002

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Abstract. Easy observation of the fundus oculi makes retinopathy the most frequently reported chronic complication of diabetes and, consequently, the one we know best in terms of epidemiology and natural history. Achieving near-normal levels of blood glucose and blood pressure provides empirical though powerful tools for clinicians to delay the onset and progression of diabetic retinopathy. Even when these measures have failed and retinopathy becomes sight-threatening, laser photocoagulation has proven remarkably effective. Nonetheless, retinopathy remains a leading cause of blindness and there is little evidence that diabetes-related visual loss is decreasing in industrialized countries. This may result from the mixed blessing of prolonged survival of patients who had become diabetic when metabolic control was pursued less fastidiously than today. Screening for sight-threatening retinopathy is the most cost-effective medical procedure known and should help optimise the use of diagnostic and therapeutic resources, but its widest deployment still meets with inertia and lack of interest within most health care systems. Improving clinical skills and technology, however, allow us to take a more optimistic look at the future, as pathogenesis-targeted forms of treatment are being developed and tested through appropriately powered clinical trials. [Diabetologia (2002[Diabetologia ( ) 45:1617[Diabetologia ( -1634

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“…Fluorescein angiography tends not to be helpful because profuse leakage from the disc vessels can occur in both conditions. 3 From a management standpoint, diabetic papillopathy should be a diagnosis of exclusion, following investigation of other causes of swollen discs. This report highlights the importance of careful funduscopy to identify coexisting severe diabetic retinopathy and, in particular, optic disc neovascularisation.…”

Section: Commentmentioning

confidence: 99%

“…2 In another study, the pressure-lowering effect of phacoemulsification in glaucoma patients was not effective until a year later. 3 The mechanism by which phacoemulsification lowers lOP is unclear, but it is thought to be related to the…”

Section: Commentmentioning

confidence: 99%