| Concerning diabetic ocular complications,diabeticretinopathy and macular edema have been wellinvestigated.However,the concepts of optic neuropathy indiabetic patients have not been clearly described.Optic nerveinvolvement can lead to visual loss and blindness.So,diabeticoptic neuropathy needs sufficient attention. Especially inpatients undergoing diabetic retinopathy combined opticneuropathy, the diagnosis of optic neuropathy shouldn't beoverlooked.. Optic neuropathy in diabetics can be classified asischemic optic neuropathy and diabetic papillopathy.In thecurrent study,the relationship between diabetic opticneuropathy and the severity of diabetic retinopathy is rarelyreported.In this study,we examined the clinical characteristicsof diabetic retinopathy combined diabetic papillopathy anddiabetic retinopathy combined ischemic optic neuropathy,andinvestigated the relationship between diabetic retiopathy anddiabetic optic neuropathy.Subjects and Methods : The study retrospectivelyreviewed the medical records and fundus fluoresceinangiography results of 1126 patients(2034 eyes) who wereperformed with fundus fluorescein angiography and diagnosedas diabetes retinopathy between January,2000 andDecember,2004.According to the accepted diabetic retinopathycriteria ,there are 1022 eyes with nonproliferative diabeticretinopathy and 1022 eyes with proliferative diabeticretinopathy.In 1126 patients,there are 279 patients whosediabetic course were under 5 years,476 patients whose diabeticcourse were between 5 years and 10 years,255 patients whosediabetic course were between 10 years and 15 years and 116patients whose diabetic course were above 15 years. Studyedthe ocular fundus photographs, fundus fluorescein angiographyand Visual field of these patients.Diabetic papillopathy andanterior ischemic optic neuropathy were diagnosed among thesepatients according to accepted criteria. The diagnosis ofdiabetic papillopathy was based on:(1) Fundus fluoresceinangiography: In the early phase of the angiograms, optic disccapillary vessel dilatation is visible;During the middle to latephases,extravascular leakage gradually appeared and there isdye leakage seen in the late phase on optic disc.Optic discdiffuse late-phase hyperfluorescence is seen in these -6 -patients.(2)Fundus fingdings:disc swelling and peripapillarycapillary dilatation are seen.(3)Visual field examinations werenormal except for enlargement of the blind spot in theeye .(4)Other possible etidogies of optic disk swelling wereexcluded.The diagnosis of Anterior ischemic optic neuropathywas based on:(1) Fundus fluorescein angiography: In the earlyphase of the angiograms, irregular and delayed filling is visibleon optic disc.During the late phases,disc hyperfluorescenceis seen due to extravascular leakage and capillary vesseldilatation.(2)Fundus fingdings: optic disc edema or segmentalpallor,with hemorrhages are seen. (3)Visual field examinationsoften present with altitudinal visual field defects .As aresult,42 eyes of 35 patients met the study definition of diabeticoptic neuropathy. The following related clinical data of thesepatients were documented: age,unilateral or bilateralonset,sex,visual acuity(best –corrected visual acuity) , disc andretinal findings,ancillary test results,and clinicalcourse .Studyed the relationship between diabetic opticneuropathy and diabetic retinopathy stages .At the same timeneovessels on the disc were differentiated with opticneuropathy .Results (1) 15 eyes of 11 patients met the study definitionof diabetic papillopathy. The occurrence rate in this group of2034 eyes with diabetic retiopathy is 0.74%. 4 patients werebilateral . Patients were generally older (mean age, 47 years)and of a broader age range (37 to 62 years). Visual acuityranged from finger counting to 0.8;and had diabetes mellitusduration from 0.5 year to 4 years (mean 2 years). 27 eyes of24 patients met the study definition of ischemic opticneuropathy. The occurrence rate is 1.33%. Age range from 39to 62 years(mean age, 54 years). Visual acuity ranged fromfinger counting to 0.8;and had diabetes mellitus durationfrom 1 year to 18 years (mean 6.7 years). (2) In 1022 eyes with nonproliferative diabetic retinopathydeveloped diabetic papillopathy 12 eyes(1.17%) and ischemicoptic neuropathy 22 eyes(2.15%). In 1012 eyes withproliferative diabetic retinopathy developed diabeticpapillopathy 3 eyes(0.29%) and ischemic optic neuropathy 5eyes(0.49%).The occurrence rate of nonproliferative diabeticretinopathy combined diabetic papillopathy was significantlyhigher than proliferative diabetic retinopathy. There was astatistically significant difference. (p=0.021,p<0.05).The...
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