Optic disc edema in juvenile-onset diabetes
P. R. Pavan, L. M. Aiello, M. Z. Wafai, J. C. Briones, J. G. Sebestyen and M. J. Bradbury
The clinical and photographic records of patients with juvenile-onset
diabetes and nonneurologic disc edema were reviewed to determine the
natural history of the disease. Six female and two male patients, 14 to 40
years old, who had had diabetes for seven to 22 years had no visual
complaints or mild blurring. All had 6/9 or better visual acuity and normal
blood pressure. Visual fields were normal or showed an enlarged blind spot.
The edematous discs had superficial, dilated, radially oriented,
fluorescein-incontinent capillaries. Two patients had simultaneous
neovascularization of the disc. Three received laser photocoagulation, and
five received no therapy. In the seven followed up for six months or more,
the edema resolved, resulting in 6/6 visual acuity. These findings suggest
the edema resulted from a reversible vasculopathy that, due to few
symptoms, may be more common than is presently appreciated.
