Jornal de Oftalmologia Clínica e Experimental
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Bilateral Posterior Ischaemic Optic Neuropathy Secondary to Diabetic Ketoacidosis: An Unfortunate Cure for Diabetic Retinopathy

William Cunningham, Sarah Mason, John Cain and Ian McAllister

Purpose: To report a case of bilateral posterior ischaemic optic neuropathy secondary to diabetic ketoacidosis.

Methods: Case history with multimodal imaging, including colour fundus photography, fundus fluorescein angiography, optical coherence tomography, and magnetic resonance imaging with high resolution diffusion weighted imaging.

Results: We report a 29-year-old female with bilateral posterior ischaemic optic neuropathy following diabetic ketoacidosis resulting in no perception of light vision in both eyes, confirmed on magnetic resonance imaging with high resolution diffusion weighted imaging. We also document the resolution of proliferative diabetic retinopathy following the onset of bilateral optic nerve atrophy.

Conclusion: Bilateral posterior ischaemic optic neuropathy can occur following diabetic ketoacidosis, and proliferative diabetic retinopathy can resolve following the onset of optic nerve atrophy. If posterior ischaemic optic neuropathy is suspected, magnetic resonance imaging with high resolution diffusion weighted imaging may aid in confirming the diagnosis.