Sebai I, Chihaoui M, Elfeleh E, Oueslati I, Yazidi M, Chebbi A, Chaker F, Slimane H
Service d'endocrinologie, hôpital La Rabta, faculté de médecine de Tunis, université Tunis, El Manar, Tunisie.
Service d'endocrinologie, hôpital La Rabta, faculté de médecine de Tunis, université Tunis, El Manar, Tunisie.
Rev Med Interne. 2019 Mar;40(3):188-190. doi: 10.1016/j.revmed.2018.08.007. Epub 2018 Aug 30.
Diabetic papillopathy is a rare ocular complication of diabetes. Its pathophysiology is not well known. It is a unilateral or bilateral optic disc edema with variable degrees of visual loss.
A 66-year-old woman, with a twelve years old type 2 diabetes mellitus, suddenly presented a unilateral decreased vision. Her ocular examination was normal eight months earlier. Ocular examination, radiological investigations and laboratory analysis were conclusive of diabetic papillopathy. Medical history revealed a recent rapid improvement of blood glucose control after intensification of insulin therapy. A visual acuity improvement with spontaneous regression of papillary edema was observed.
There is a risk of diabetic papillopathy associated with the rapid control of blood glucose levels after intensification of insulin therapy, even in diabetic patients without known retinopathy.
糖尿病性视乳头病变是糖尿病一种罕见的眼部并发症。其病理生理学尚不明确。它是一种伴有不同程度视力丧失的单侧或双侧视盘水肿。
一名66岁女性，患2型糖尿病12年，突然出现单侧视力下降。8个月前她的眼部检查正常。眼部检查、影像学检查和实验室分析确诊为糖尿病性视乳头病变。病史显示在强化胰岛素治疗后血糖控制近期迅速改善。观察到视力改善且视乳头水肿自发消退。
即使在无已知视网膜病变的糖尿病患者中，强化胰岛素治疗后血糖水平的快速控制也存在糖尿病性视乳头病变的风险。
