Keely K A, Yip B
Brooklyn/St. Albans Veterans Administration Medical Center, New York, USA.
J Am Optom Assoc. 1997 Sep;68(9):595-603.
Diabetic papillopathy is a benign unilateral or bilateral optic neuropathy with transient optic disk edema and minimal reduction in visual function. The optic disk edema typically resolves in a few months with no resulting optic atrophy and minimal or no decrease in acuity. The exact etiology of the disk edema is unknown, but theories include retinal vascular leakage into and surrounding the optic nerve and disruption of axoplasmic flow resulting from microvascular disease of the optic nerve head vasculature.
Two adult patients receiving insulin for type II diabetes mellitus manifested bilateral disk edema and minimal visual dysfunction. Both patients showed funduscopic evidence of mild-to-moderate nonproliferative diabetic retinopathy O.D. and O.S., and one patient had clinically significant macular edema in both eyes. The diagnosis in both cases was diabetic papillopathy. Both patients had significant resolution of their disk edema in 3 to 6 months, with stable acuities and no signs of optic atrophy.
Although diabetic papillopathy is a well-known clinical entity in patients with type I diabetes, the clinical profile can be expanded to include individuals with type II diabetes.
糖尿病性视乳头病变是一种良性的单侧或双侧视神经病变，伴有短暂性视盘水肿，视功能仅有轻微减退。视盘水肿通常在数月内消退，不会导致视神经萎缩，视力减退轻微或无减退。视盘水肿的确切病因尚不清楚，但理论包括视网膜血管渗漏至视神经及其周围，以及视神经乳头血管系统微血管疾病导致的轴浆流中断。
两名接受胰岛素治疗的II型糖尿病成年患者出现双侧视盘水肿和轻微视功能障碍。两名患者双眼眼底镜检查均显示轻度至中度非增殖性糖尿病视网膜病变，其中一名患者双眼有临床上显著的黄斑水肿。两例诊断均为糖尿病性视乳头病变。两名患者视盘水肿在3至6个月内明显消退，视力稳定，无视神经萎缩迹象。
虽然糖尿病性视乳头病变在I型糖尿病患者中是一种广为人知的临床病症，但临床特征可扩展至包括II型糖尿病患者。
