Endocrine Abstracts

Introduction: Diabetes is the cause of ophthalmological complications that are all the more severe when the balance of diabetes is precarious. Among the non-retinal ocular targets of diabetes is damage to the optic nerve. The diagnosis of diabetic mononeuritis should only be made after excluding other causes of neuropathy.

Observation: We report the case of a patient referred to our service for equilibration of diabetes. This is a 59-year-old patient, type 1 diabetic for 30 years, coronary stent 6 years ago. In addition, the patient presents a ptosis of the right eye which appeared two weeks ago. As part of the exploration of this symptomatology, a brain scan and a brain MRI were requested. The scan came back with no abnormalities. MRI showed moderate thickening of the optic nerve consistent with optic neuritis. The etiological investigation was continued by serological, enzymological and immunological tests. CMV and HIV serologies were negative. The angiotensin converting enzyme level was normal. Polymorphonuclear anti-cytoplasm antibodies and native anti-DNA antibodies also came back negative. On biology, he had a fasting blood sugar level of 25.1 mmol/l and a glycated hemoglobin of 12.9%. The patient was put under hygieno-dietetic rules, metformin and insulin therapy. The evolution was marked by the normalization of the glycemic figures after one week of hospitalization.

Conclusions: Optimal glycemic control reduces the risk of diabetic retinopathy but also of the occurrence of other ocular pathologies, in particular oculomotor damage and damage to the optic nerve responsible for reduced visual acuity.