Regillo C D, Brown G C, Savino P J, Byrnes G A, Benson W E, Tasman W S, Sergott R C
Retina Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pa., USA.
Arch Ophthalmol. 1995 Jul;113(7):889-95. doi: 10.1001/archopht.1995.01100070063026.
To better define the spectrum of patient characteristics and fundus findings in patients with a presumably unique clinical entity referred to as diabetic papillopathy.
Retrospective series.
A university-based referral practice.
We retrospectively reviewed the medical records of all diabetic patients with benign, transient disc swelling who were evaluated at our institution from 1986 to 1992. Data pertaining to patient demographics, visual acuity and symptoms, disc and retinal findings, ancillary test results, and clinical course were collected.
Twenty-seven eyes of 19 patients met the study definition of diabetic papillopathy. Patients were generally older (mean age, 50 years) and of a broader age range (19 to 79 years) compared with those in prior reports. Two thirds of patients had type II diabetes. Disc swelling was consistently hyperemic and, on average, resolved within 3.7 months. Macular edema was a frequent associated finding (70% of eyes) as was significant capillary nonperfusion (52% of tested eyes). Only four eyes (15%) had final visual acuities of less than 20/50 and each had prominent macular edema. Cup-disc ratio analysis of uninvolved eyes revealed a significantly small physiologic cup.
The clinical profile of diabetic papillopathy can be expanded to include people who are older or have type II diabetes and that affected eyes commonly have macular edema or retinal vascular changes that can adversely affect the visual outcome. Last, a small physiologic cup may represent an anatomic predisposition to the condition.
为了更好地界定一种被称为糖尿病性视乳头病变的可能独特临床实体患者的特征谱和眼底表现。
回顾性系列研究。
一所大学附属医院的转诊业务。
我们回顾性分析了1986年至1992年在我们机构接受评估的所有患有良性、暂时性视盘肿胀的糖尿病患者的病历。收集了与患者人口统计学、视力和症状、视盘和视网膜表现、辅助检查结果以及临床病程相关的数据。
19例患者的27只眼符合糖尿病性视乳头病变的研究定义。与先前报告中的患者相比，这些患者通常年龄更大（平均年龄50岁），年龄范围更广（19至79岁）。三分之二的患者患有II型糖尿病。视盘肿胀始终充血，平均在3.7个月内消退。黄斑水肿是常见的伴随表现（70%的眼），显著的毛细血管无灌注也是如此（52%的受检眼）。只有4只眼（15%）最终视力低于20/50，且每只眼都有明显的黄斑水肿。对未受累眼的杯盘比分析显示生理性杯明显较小。
糖尿病性视乳头病变的临床特征可扩展至包括年龄较大或患有II型糖尿病的人群，且受累眼通常有黄斑水肿或视网膜血管改变，这些可对视功能预后产生不利影响。最后，生理性杯较小可能代表该疾病的一种解剖学易患因素。
