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Development of bilateral, nonarteritic anterior ischemic optic neuropathy in an eye with diabetic papillopathy.

BACKGROUND: Diabetic papillopathy and anterior ischemic optic neuropathy are different clinical entities with different prognoses. We describe a case of diabetic papillopathy that developed into bilateral nonarteritic anterior ischemic optic neuropathy (AION).

CASE: A 58-year-old woman with diabetes mellitus had bilateral disc elevation. Goldmann perimetry showed altitudinal hemianopsia in the left eye. The early phase of fluorescein angiography showed hypoperfusion in the superior segment of the left optic disc indicating AION in the left eye.

OBSERVATIONS: During the follow-up period, the visual field of the left eye was further constricted and that of the right eye also developed signs of AION, suggesting that bilateral anterior ischemic optic neuropathy had developed. After steroid pulse therapy, her vision recovered slightly, but the visual field remained constricted in both eyes. The optic discs had a low cup/disc ratio.

CONCLUSIONS: Our findings demonstrated that diabetic papillopathy can precede the development of nonarteritic anterior ischemic optic neuropathy.

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