Abstract
Diabetic papillopathy (DP) is a rare ocular complication of diabetes presenting as acute disc edema. It is characterized by minimal or no visual symptoms and has tendency to resolve spontaneously in most of the patients with no visual sequel. Visual debility, if present, is attributable to diabetic macular edema (DME), advanced diabetic retinopathy or conversion to ischemic optic neuropathy. We report a case of 33 years old female who presented with bilateral papillopathy with best corrected visual acuity (BCVA) of 6/6 in both eyes. She had associated severe non proliferative diabetic retinopathy but noDME. On follow up, thepatient had good metabolic control and clinical improvement in DP, but she developed sudden diminution of vision in left eye as a result of non ischemic central retinal vein occlusion (CRVO) which was characterized by BCVA of 6/36, dilated tortuous veins and DME. No specific cause of non-ischaemicCRVOwas revealed on detailed work up. Structural and functional improvement was seenon monthly intravitrealanti vascular endothelial growth factor(VEGF) administration.Her BCVA post threeinjectionstood at 6/18. This is to report the possibility of development of CRVO in DP and highlight the need for close follow-up of such patients even in presence of strict diabetic control.
Highlights
Diabetes mellitus(DM) is responsible for a myriad of ocular morbidi es of which posterior segment involvement is seen in diabe c re nopathy (DR) and diabe c papillopathy (DP)
We report a case of DP which converted to central re nal vein occlusion (CRVO) on follow up with acute deteriora on of vision
DP in young even in absence of other risk factors may lead to CRVO
Summary
Diabetes mellitus(DM) is responsible for a myriad of ocular morbidi es of which posterior segment involvement is seen in diabe c re nopathy (DR) and diabe c papillopathy (DP). DP is a diagnosis of exclusion where other infec ous, inflammatory and infiltra ve causes of disc edema as well as increased intracranial tension have been ruled out These pa ents have no or minimal visual symptoms comprising of painless mild blurring or distor on of vision. On two months follow up, BCVA OU was 6/6, disc remained hyperemic, with resolving disc edema Her blood sugar was in control on con nued insulin therapy. Her pupillary reac on, color vision, contrast sensi vity and visual field remained normal. Color vision, contrast sensi vity and visual field remained normal She had developed non ischaemic CRVO with macular edema measuring 837μ (central macular thickness [CMT] by OCT) in le eye. Her BCVA improved not be er than 6/18, the cause of which could not be explained
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call