背景:糖尿病性乳头病是一种罕见的糖尿病眼部并发症。其病理生理学尚不为人所知。它是单侧或双侧视盘水肿,伴有不同程度的视力丧失。
方法:一个66岁的女人,患有12岁的2型糖尿病,突然出现单侧视力下降。八个月前她的眼部检查正常。眼部检查,放射学检查和实验室分析是糖尿病性乳头状病变的结论。病史显示,强化胰岛素治疗后血糖控制最近迅速改善。观察到视敏度改善,乳头状水肿自发消退。
结论:强化胰岛素治疗后血糖水平的快速控制存在糖尿病性乳头病的风险,甚至在没有已知视网膜病变的糖尿病患者中。
BACKGROUND: 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.
METHODS: 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.
CONCLUSIONS: 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.