Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Am J Med Sci. 2019 Feb;357(2):164-167. doi: 10.1016/j.amjms.2018.09.013. Epub 2018 Oct 4.
The presenting symptoms of diabetic ketoacidosis (DKA) include abdominal pain, polyuria and nausea. Diabetes has well known chronic ocular complications like glaucoma, cataracts and retinopathy. We report a case of reversible blindness as a presenting manifestation of DKA that has been reported in literature only 3 times previously. Our objective is to highlight a rare manifestation of a common disease. A 59-year-old male presented with painless vision loss for 3 days and was found to have DKA. The blindness was completely reversed with insulin and bicarbonate treatment. The dramatic presentation and reversibility of blindness was found to be intimately tied with the pH of the patient's serum. Our report gives mechanistic insight for this interesting condition. Clinicians should be aware of reversible blindness as a complication of DKA. Timely correction of the severe acidosis and other metabolic disturbances of DKA may be instrumental in preventing permanent vision loss.
糖尿病酮症酸中毒（DKA）的主要表现为腹痛、多尿和恶心。糖尿病还有众所周知的慢性眼部并发症，如青光眼、白内障和视网膜病变。我们报告了一例以 DKA 为首发表现的可逆性失明，这种情况在文献中仅报道过 3 次。我们的目的是强调一种常见疾病的罕见表现。一名 59 岁男性因无痛性视力丧失 3 天就诊，被诊断为 DKA。通过胰岛素和碳酸氢盐治疗，失明完全逆转。这种戏剧性的表现和失明的可逆性与患者血清的 pH 值密切相关。我们的报告为这种有趣的情况提供了机制上的见解。临床医生应注意到 DKA 是失明的一种并发症。及时纠正 DKA 的严重酸中毒和其他代谢紊乱可能有助于防止永久性视力丧失。
