Periocular corticosteroids in diabetic papillopathy.
OBJECTIVE
To ascertain the therapeutic effect of periocular corticosteroids in diabetic papillopathy.


METHODS
Prospectively, five consecutive adult-onset diabetic patients with symptomatic diabetic papillopathy underwent visual fields and fluorescein angiography before and after superonasal subtenon injection of corticosteroids.


RESULTS
The median duration of papillopathy was 2.5 weeks by ophthalmoscopy and 3 weeks by fluorescein angiography. The median recovery time of best-spectacle-corrected visual acuity was 2 weeks. Two patients developed sequential diabetic papillopathy, and both reported faster visual recovery and better subjective vision in treated eyes. In these two patients, the final best-spectacle-corrected visual acuity and visual evoked responses were comparable between the two eyes, while automated visual fields were less constricted in treated eyes. Complications included ocular hypertension, mild progression of cataract, and mild ptosis in one patient each.


CONCLUSIONS
Periocular corticosteroids shortened the duration of diabetic papillopathy from a reported median of 5 months to 3 weeks in the present uncontrolled observational study, partly by their angiostatic and antioedema effects at the level of the anterior optic nerve. Intraocular pressure needs to be monitored in eyes receiving periocular corticosteroids.
Mansour
A M
AM
Department of Ophthalmology, American University of Beirut, Beirut, Lebanon. r.ahmad@cyberia.net.lb
El-Dairi
M A
MA
Shehab
M A
MA
Shahin
H K
HK
Shaaban
J A
JA
Antonios
S R
SR
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy / Q000379:methods; D009898:Optic Disk; D009901:Optic Nerve Diseases / Q000188:drug therapy* / Q000209:etiology; D010211:Papilledema / Q000188:drug therapy / Q000209:etiology; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects; D014794:Visual Fields / Q000187:drug effects
D000305:Adrenal Cortex Hormones