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[糖尿病性视乳头病变与妊娠。临床贡献及发病机制探讨]

[Diabetic papillopathy and pregnancy. Clinical contribution and pathogenetic considerations].

作者信息

Cillino S, Lodato G, Scimemi M

出版信息

J Fr Ophtalmol. 1985;8(6-7):459-66.

PMID:2416795
Abstract

Bilateral mild diabetic retinopathy and disc swelling occurred in a young woman with type I diabetes during the second month of pregnancy. The disc edema showed the typical pattern of diabetic papillopathy (D.P.). This is a recently discovered syndrome of juvenile diabetics characterized by transient bilateral edema of the optic disc with minimal functional impairment. The features of D.P. and two different pathogenetical hypotheses, ischemic and dysmetabolic, expressed by other authors, are listed in detail. The case described showed a particular evolution, with bilateral prepapillary transitory neovascularization followed by scant glial reaction. Moreover pattern VEPs analysis showed a clearly increased latency. These findings suggest that both dysmetabolic (VEPs increased latency) and and ischemic (neovascularization) stimuli are responsible for D.P., even if differences with typical ischemic optic neuropathy are evident.

摘要

一名患有I型糖尿病的年轻女性在怀孕第二个月时出现双侧轻度糖尿病性视网膜病变和视盘肿胀。视盘水肿呈现出典型的糖尿病性视乳头病变(D.P.)模式。这是一种最近发现的青少年糖尿病综合征,其特征为视盘双侧短暂性水肿且功能损害极小。详细列出了D.P.的特征以及其他作者提出的两种不同的发病机制假说,即缺血性和代谢紊乱性。所描述的病例呈现出一种特殊的演变过程,先是双侧视乳头前短暂性新生血管形成,随后是少量的胶质反应。此外,图形视觉诱发电位(VEP)分析显示潜伏期明显延长。这些发现表明,代谢紊乱(VEP潜伏期延长)和缺血(新生血管形成)刺激均与D.P.有关,即便与典型的缺血性视神经病变存在明显差异。

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