Diabetic papillopathy in type II diabetic patients

Purpose: To evaluate the patient characteristics and fundus findings of patients with type II diabetes presenting with diabetic papillopathy. Methods: The authors retrospectively reviewed the medical records of 3,235 patients with diabetes followed in their institution since 1986 and identified the patients with unilateral or bilateral transient disk swelling and without significant deterioration of best-corrected visual acuity. The authors investigated patient demographics, symptoms, fundus findings, ancillary test results, and clinical course of those patients. Results: Twenty-four eyes of 16 patients with type II diabetes mellitus met the criteria. Patients had a mean age of 57.1 (+/-8.8) years and had diabetes mellitus of long duration (mean 10.0 +/- 8.6 years). Approximately half of the patients had poor metabolic control. Disk swelling was bilateral in 8 (50%) patients and resolved in an average of 7.8 +/- 3.7 months. A total of 13 (54%) eyes had nonproliferative and 2 (8%) eyes had proliferative diabetic retinopathy at presentation. In 4 (17%) eyes retinopathy progression into the proliferative stage occurred and panretinal photocoagulation was performed. Conclusions: Diabetic papillopathy may be found in older patients with type II diabetes. Nonproliferative or proliferative diabetic retinopathy as well as macular edema may also be associated with this disorder.