Anterior ischemic optic neuropathy. VI. In juvenile diabetics.

3 cases of acute optic neuropathy in juvenile diabetics are reported. The neuropathy included initially optic disc edema (ODE), usually with prominent, dilated and frequently telangiectatic vessels over the disc, and later, generally, development of optic disc-related visual field defects. On resolution of the neuropathy, the disc was normal in all eyes except for a mild pallor in one, and the visual acuity and fields recovered to normal. 2 of the patients also had early diabetic retinopathy. The nature of the optic neuropathy is discussed. We feel the available evidence indicates that the condition most likely represents a mild or subclinical anterior ischemic optic neuropathy (AION) despite the youth of the patient. It is pertinent to note that AION can vary widely not only in severity (from subclinical to severe) but also in age distribution (from juvenile to elderly), and the subject is discussed. The clinical significance of early detection of this optic neuropathy, and the dangers of confusing it with proliferative diabetic retinopathy or ODE due to other causes, are stressed.