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Diabetic Papillopathy in Pregnancy: A Marker for Progression to Proliferative Retinopathy

Bargiota, Alexandra MD, PhD; Kotoula, Maria MD; Tsironi, Evangelia MD, PhD; Koukoulis, Georgios MD, PhD

doi: 10.1097/AOG.0b013e318216ecd7
Case Reports
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BACKGROUND: Diabetic papillopathy is an uncommon cause of transient acute optic disc edema, and during pregnancy it may be easily confused with other more serious disorders that may result in acute visual loss.

CASE: We present a case of acute bilateral optic disc edema attributable to diabetic papillopathy in a young woman with an unplanned pregnancy and childhood-onset type 1 diabetes mellitus. The patient presented 16 months after fetal death of unknown etiology at 26 weeks of gestation with acute visual impairment in both eyes; severe proliferative retinopathy was diagnosed. Despite immediate therapeutic intervention with panretinal laser photocoagulation, the patient is legally blind.

CONCLUSION: Early recognition of diabetic papillopathy in pregnancy is important to prevent unnecessary testing, invasive procedures, and inappropriate treatment. Patients with diabetic papillopathy should be monitored closely even after delivery because this condition may be associated with rapid progression to proliferative retinopathy.

Diabetic papillopathy in pregnancy may be misdiagnosed and is associated with rapid progression to proliferative retinopathy and visual loss.

From the Departments of Endocrinology and Metabolic Diseases and Ophthalmology, University Hospital of Larissa, Larissa Greece.

Corresponding author: Alexandra Bargiota, Department of Endocrinology and Metabolic Diseases, University Hospital of Larissa, Biopolis, 41110 Larissa, Greece; e-mail: abargio@yahoo.gr.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 The American College of Obstetricians and Gynecologists