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December 1985

Tenuous Ocular Perfusion From Orthostatic Hypotension Associated With Diabetic Neuropathy

Author Affiliations

Silver Spring, Md

Arch Ophthalmol. 1985;103(12):1782. doi:10.1001/archopht.1985.01050120012002

To the Editor.  —Diabetic retinopathy, papillopathy, keratopathy, and early cataract formation are the principal ocular changes in diabetes mellitus attributed to vascular and biochemical changes. Ten percent of cases of oculomotor palsy are attributed to diabetes mellitus, which is due to atherosclerosis of the vasa nervora of the cranial nerves and nuclei.1 Retinal vascular changes associated with severe diabetic neuropathy have not been emphasized in the ophthalmic literature. We herein report a case of ocular hypoperfusion associated with severe diabetic neuropathy and orthostatic hypotension.

Report of a Case.  —A 45-year-old man with a ten-year history of diabetes mellitus was referred for additional panretinal laser photocoagulation of the left eye to treat proliferative diabetic retinopathy. He had previously received a short session of laser applications that was discontinued because of severe ocular pain. His visual acuity was 20/30 OU, and intraocular pressure was 9 mm Hg in both eyes. Red

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