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

Dorchy, Harry; Toussaint, Dominique; Verougstraete, Claire; Lemiere, B

doi:10.1007/bf00442134

Cited by 9 publications

(4 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is often bilateral, but may be asymmetric with sequential onset. Disc swelling has been noted to occur after tightening of control, 2 as seen in our patient; CME may also be present 3 . Miss OL's poor acuity appeared to be largely secondary to the presence of CME, as there was excellent visual recovery with its resolution.…”

Section: Discussionsupporting

confidence: 61%

“…The absence of retinal ischaemia on the fluorescein angiogram and swelling of the entire optic nerve heads in our patient confirms that neovascularization of the discs was not present. However, as illustrated by our case, those with disc swelling are likely to develop retinal ischaemia, which may lead to neovascularization after the disc swelling has resolved 1−4 . The disc swelling resolves without specific ocular treatment over several months leaving a disc that is either normal in appearance or has mild pallor from anterior ischaemic optic neuropathy 3 …”

Section: Discussionmentioning

confidence: 78%

See 1 more Smart Citation

Optic disc swelling in an adolescent with insulin dependent diabetes mellitus

Fraser‐Bell

Capon

2002

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

A 14-year-old Ukrainian girl with uncontrolled insulin dependent diabetes developed bilateral optic disc swelling when diabetic treatment was instituted. There was no retinal ischaemia. The disc swelling resolved completely over 8 months without specific ocular therapy. Disc swelling in juvenile diabetics must be differentiated from disc neovascularization. These patients may develop retinal ischaemia and neovascularization after the disc changes resolve.

show abstract

Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 78%

Optic disc swelling in an adolescent with insulin dependent diabetes mellitus

Fraser‐Bell

Capon

2002

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

show abstract

“…Pathological features include vascular leakage, retinal infarction, exudation and intraretinal haemorrhages (Regillo et al 1995); the condition thus has many characteristics in common with diabetic retinopathy. In addition, case reports suggest that this complication may follow a rapid improvement in metabolic control (Dorchy et al 1985;Agardh et al 1988). For these reasons, diabetic papillopathy can be used as a model to test for a potential association between metabolic control variability and the diabetic eye complications that ultimately lead to intraocular surgery.…”

Section: Risk Factorsmentioning

confidence: 99%

Intraocular surgery in a large diabetes patient population: risk factors and surgical results

Ostri

2014

Acta Ophthalmologica

View full text Add to dashboard Cite

The prevalence of diabetes is on the increase in developed countries. Accordingly, the prevention and treatment of vision-threatening diabetic eye complications is assuming greater importance.The overall aim of this thesis (Ostri 2014) is to analyse the risk factors for intraocular surgery in a large diabetes population and to report the surgical results. The specific objectives are to (i) estimate the incidence of diabetic vitrectomy and analyse risk factors (Study I), (ii) report long-term results, prognostic factors and incidence of cataract surgery after diabetic vitrectomy (Study II), (iii) report results and prognostic factors after cataract surgery in diabetes patients (Study III) and (iv) analyse risk factors for diabetic papillopathy (Study IV). In the latter study, diabetic papillopathy is used as a model to test for a potential association between metabolic control variability and the diabetic eye complications that ultimately lead to intraocular surgery.The studies are based on a closeto-complete national surgery register and a large, closely followed diabetic retinopathy screening population.Study I (cohort study, 3980 type 1 diabetes patients) illustrates that diabetic vitrectomy is rarely required in a diabetes population with varying degrees of retinopathy. Scatter laser treatment is the first-line treatment of proliferative diabetic retinopathy, but about half of the patients were not fully treated with scatter laser before surgery, which suggests that a more aggressive scatter later treatment strategy could have further reduced the incidence of surgery in the population.

show abstract

“…In addition, case reports suggest that this complication may follow a rapid improvement in metabolic control (Dorchy et al. ; Agardh et al. ).…”

Section: Introductionmentioning

confidence: 99%

Intraocular surgery in a large diabetes patient population: risk factors and surgical results

Ostri

2014

Acta Ophthalmologica

View full text Add to dashboard Cite

The prevalence of diabetes is on the increase in developed countries. Accordingly, the prevention and treatment of vision‐threatening diabetic eye complications is assuming greater importance. The overall aim of this thesis is to analyse risk factors for intraocular surgery in a large diabetes population and to report surgical results. The specific objectives are to (1) estimate the incidence of diabetic vitrectomy and analyse risk factors (Study I), (2) report long‐term results, prognostic factors and incidence of cataract surgery after diabetic vitrectomy (Study II), (3) report results and prognostic factors after cataract surgery in diabetes patients (Study III) and (4) analyse risk factors for diabetic papillopathy with emphasis on metabolic control variability (Study IV). All studies are based on a close‐to‐complete national surgery register and a large, closely followed diabetic retinopathy screening population. Study I (cohort study, 3980 type 1 diabetes patients) illustrates that diabetic vitrectomy is rarely required in a diabetes patient population with varying degrees of diabetic retinopathy. The risk of reaching diabetic vitrectomy increases fourfold with poor metabolic control, defined as glycosylated haemoglobin A1c > 75 mmol/mol (~9%), which points to good metabolic control as an important preventive measure. Study II (cohort study, 167 diabetes patients) shows that most diabetic vitrectomy patients stand to gain visual acuity ≥0.3 after surgery. Visual acuity is stable after 1 year, and the stability is maintained through 10 years of follow‐up. The use of silicone oil for endotamponade is a consistent long‐term predictor of low vision after surgery. The risk of requiring cataract surgery after diabetic vitrectomy is substantial, and the risk increases if silicone oil is used. Study III (cohort study, 285 diabetes patients) shows, on the other hand, that diabetes patients can expect a significant improvement in visual acuity after cataract surgery, regardless of the degree of diabetic retinopathy. Poor preoperative visual acuity, a high degree of diabetic retinopathy and advanced age are predictors of a poor visual acuity after surgery. The risk of diabetic macular oedema after surgery is 4%. Finally, Study IV (case–control study, 2066 type 1 diabetes patients) demonstrates that diabetic papillopathy shares characteristics with diabetic retinopathy. The risk of experiencing diabetic papillopathy increases markedly with a drastic, recent reduction in glycosylated haemoglobin A1c and a small optic disc. This lends support to the theory that diabetic eye complications may occur in anatomically predisposed patients in response to metabolic control variability. Overall, results after intraocular surgery in diabetes patients are favourable. Surgery, however, is associated with costs to society, patient discomfort and risk of complications. This thesis provides an analysis of risk factors for intraocular surgery and identifies prognostic factors for visual acuity after surgery, which can be used ...

show abstract

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

Cited by 9 publications

References 9 publications

Optic disc swelling in an adolescent with insulin dependent diabetes mellitus

Optic disc swelling in an adolescent with insulin dependent diabetes mellitus

Intraocular surgery in a large diabetes patient population: risk factors and surgical results

Intraocular surgery in a large diabetes patient population: risk factors and surgical results

Contact Info

Product

Resources

About