Periocular corticosteroids in diabetic papillopathy

Abstract

Purpose To ascertain the therapeutic effect of periocular corticosteroids in diabetic papillopathy. Methods Prospectively, five consecutive adult-onset diabetic patients with symptomatic diabetic papillopathy underwent visual fields and fluorescein angiography before and after superonasal subtenon injection of corticosteroids. Results The median duration of papillopathy was 2.5 weeks by ophthalmoscopy and 3 weeks by fluorescein angiography. The median recovery time of best-spectaclecorrected visual acuity was 2 weeks. Two patients developed sequential diabetic papillopathy, and both reported faster visual recovery and better subjective vision in treated eyes. In these two patients, the final bestspectacle-corrected visual acuity and visual evoked responses were comparable between the two eyes, while automated visual fields were less constricted in treated eyes. Complications included ocular hypertension, mild progression of cataract, and mild ptosis in one patient each. Conclusions Periocular corticosteroids shortened the duration of diabetic papillopathy from a reported median of 5 months to 3 weeks in the present uncontrolled observational study, partly by their angiostatic and antioedema effects at the level of the anterior optic nerve. Intraocular pressure needs to be monitored in eyes receiving periocular corticosteroids.

Diabetic papillopathy with macular edema treated with intravitreal bevacizumab

“…As mentioned earlier, periocular corticosteroid was found also to be effective in accelerating improvement of DP. [8] This suggests inflammatory elements could be involved in pathogenesis of this disorder. Recently reported, AION can present as an adverse effect of anti-VEGF.…”

Diabetic Papillopathy After Panretinal Photocoagulation Treatment With İntravitreal Ranibizumab: A Case Report

“…DP etiyolojisi çok iyi bilinmediğinden hastalığın doğal seyrini değiştiren onaylanmış bir tedavisi yoktur. Son olgu sunumlarında, tek doz intravitreal triamsinolon asetat yada intravitreal vasküler endotelyal growth faktör inhibitörünün (anti-VEGF) disk kabarıklığının azalmasında etkili olduğu gösteril-miştir (5)(6)(7)(8)(9)(10) .…”

Diabetic papillopathy with macular edema treated with intravitreal ranibizumab

“…The etiology of DP is not well understood, and there is no accepted treatment to alter its natural course. In recent case reports, treatment with a single injection of intravitreal triamcinolone acetate or intravitreal inhibitor of vascular endothelial growth factor (VEGF) was effective in reducing disk swelling 5–9. However, only one report was found in a literature search that was performed with intravitreal ranibizumab (Lucentis®; Novartis, Basel, Switzerland) injection 9.…”