Diabetic Papillopathy in Pregnancy

Abstract

Diabetic papillopathy is an uncommon cause of transient acute optic disc edema, and during pregnancy it may be easily confused with other more serious disorders that may result in acute visual loss. We present a case of acute bilateral optic disc edema attributable to diabetic papillopathy in a young woman with an unplanned pregnancy and childhood-onset type 1 diabetes mellitus. The patient presented 16 months after fetal death of unknown etiology at 26 weeks of gestation with acute visual impairment in both eyes; severe proliferative retinopathy was diagnosed. Despite immediate therapeutic intervention with panretinal laser photocoagulation, the patient is legally blind. Early recognition of diabetic papillopathy in pregnancy is important to prevent unnecessary testing, invasive procedures, and inappropriate treatment. Patients with diabetic papillopathy should be monitored closely even after delivery because this condition may be associated with rapid progression to proliferative retinopathy.