Long-term visual field changes in diabetic papillopathy

ABSTRACT

Is to evaluate the fundus and central visual field changes in patients with diabetic papillopathy after long term follow up. Twelve patients [14 eyes] with diabetic papillopathy were followed up for at least 3 years. Full clinical ophthalmological evaluation, colour fundus photography, fluorescein angiography and central automated perimetry were repeatedly performed initially and at specific intervals. All eyes presented with hyperemic optic' disc edema and minimal or no evidence of optic nerve dysfunction. Within 3-12 months, the optic disc edema completely resolved. At 1 year and later on, pallor and hypofluorescence of the optic disc and peripapillary choroidal atrophy were observed in 12 eyes. In central perimetry, enlarged blind spot only or in association with scattered scotomata was initially seen in most eyes. At 1 year, recovery of the previously detected field defects was seen in most eyes, but persistent minor defects were seen in few eyes. At 2 year and later on, inferior altitudinal and superior arcuate field defects with marked depression of the retinal sensitivity were more commonly seen. Inferior arcuate defect and superior scattered scotomata with moderate reduction of the retinal sensitivity were less commonly noticed. In all eyes, the central 5-100° were preserved. These visual field defects were not associated with corresponding retinal or significant tonometric changes. -Diabetic papillopathy may not be as benign as described before, and an ischemic factor may play a role in its pathogenesis