Optic disc edema in juvenile-onset diabetes.

The clinical and photographic records of patients with juvenile-onset diabetes and nonneurologic disc edema were reviewed to determine the natural history of the disease. Six female and two male patients, 14 to 40 years old, who had had diabetes for seven to 22 years had no visual complaints or mild blurring. All had 6/9 or better visual acuity and normal blood pressure. Visual fields were normal or showed an enlarged blind spot. The edematous discs had superficial, dilated, radially oriented, fluorescein-incontinent capillaries. Two patients had simultaneous neovascularization of the disc. Three received laser photocoagulation, and five received no therapy. In the seven followed up for six months or more, the edema resolved, resulting in 6/6 visual acuity. These findings suggest the edema resulted from a reversible vasculopathy that, due to few symptoms, may be more common than is presently appreciated.