[Diabetic papillopathy and pregnancy. Clinical contribution and pathogenetic considerations]

Bilateral mild diabetic retinopathy and disc swelling occurred in a young woman with type I diabetes during the second month of pregnancy. The disc edema showed the typical pattern of diabetic papillopathy (D.P.). This is a recently discovered syndrome of juvenile diabetics characterized by transient bilateral edema of the optic disc with minimal functional impairment. The features of D.P. and two different pathogenetical hypotheses, ischemic and dysmetabolic, expressed by other authors, are listed in detail. The case described showed a particular evolution, with bilateral prepapillary transitory neovascularization followed by scant glial reaction. Moreover pattern VEPs analysis showed a clearly increased latency. These findings suggest that both dysmetabolic (VEPs increased latency) and and ischemic (neovascularization) stimuli are responsible for D.P., even if differences with typical ischemic optic neuropathy are evident.