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Optic Nerve Hypoplasia and Maternal Diabetes Mellitus

Optic Nerve Hypoplasia and Maternal Diabetes Mellitus Abstract • Altitudinal visual field defects were discovered in four young women on routine eye or general physical examinations. This led to extensive investigations because three of them were falsely presumed to have acquired disorders of the central nervous system. In each case the defect appeared to result from congenital hypoplasia of the optic nerve associated with maternal diabetes mellitus. Congenital optic nerve hypoplasia should be included in the differential diagnosis of visual field defects even when they are discovered in adults. Hypoplasia consequent to maternal diabetes mellitus is apt to be associated with excellent visual acuity and is usually an isolated defect. The female offspring of diabetic mothers may be at greater risk than the male offspring for the development of this anomaly. References 1. Traquair HM: The ocular manifestations of head injury . Trans Ophthalmol Soc UK 1929;49:348-358. 2. Schmidt D, Buhrmann K: Inferior hemianopsia in parasellar and pituitary tumors , in Glaser JS (ed): Neuro-ophthalmology . St Louis, CV Mosby Co, 1977, vol 9, pp 236-247. 3. Newman RP, Kinkel WR, Jacobs L: Altitudinal hemianopia caused by occipital infarctions . Arch Neurol 1984;41:413-421.Crossref 4. Teuber HL. Battersby WS, Bender MD: Visual Field Defects After Penetrating Missile Wounds of the Brain . Cambridge, Mass, Harvard University Press, 1960, pp 16-17. 5. Hotchkiss M, Green WR: Optic nerve aplasia and hypoplasia . J Pediatr Ophthalmol Strabismus 1979;16:225-240. 6. Acers TE: Optic nerve hypoplasia: Septooptic-pituitary dysplasia syndrome . Trans Am Ophthalmol Soc 1981;69:425-457. 7. Ellenberger C, Runyan TE: Holoprosen-cephaly with hypoplasia of the optic nerve, dwarfism and agenesis of the septum pellucidum . Am J Ophthalmol 1970;70:960-967. 8. Edwards WC, Layden WE: Optic nerve hypoplasia . Am J Ophthalmol 1970;70:950-959. 9. Walton DS, Robb RM: Optic nerve hypoplasia . Arch Ophthalmol 1970;84:572-578.Crossref 10. Bjork A, Laurell CG, Laurell U: Bilateral optic nerve hypoplasia with normal visual acuity . J Pediatr Ophthalmol Strabismus 1981;18:18-22. 11. VanDyk HJL, Morgan KS: Optic nerve hypoplasia and young maternal age . Am J Ophthalmol 1980;89:879. 12. Hittner AM, Desmond MM, Montgomery JR: Optic nerve manifestations of cytomegalus infection . Am J Ophthalmol 1976;81:661-665. 13. Taylor D: Congenital tumours of the anterior visual system with dysplasia of the optic discs . Br J Ophthalmol 1982;66:455-463.Crossref 14. Behrens MM: Other optic nerve diseases , in Lessell S, van Dalen JTW (eds): Neurol-ophthalmology . Amsterdam, Excerpta Medica, 1982, vol 2, pp 41-59. 15. Hackenbruch Y, Meerhoff E, Besio R, et al: Familial bilateral optic nerve hypoplasia . Am J Ophthalmol 1975;79:314-320. 16. McKinna AJ: Quinine-induced hypoplasia of the optic nerve . Can J Ophthalmol 1966;1:261-263. 17. Hoyt CS: Optic disc anomalies and maternal ingestion of LSD . J Pediatr Ophthalmol Strabismus 1978;15:286-289. 18. Hoyt CS, Billson FA: Maternal anticonvulsants and optic nerve hypoplasia . Br J Ophthalmol 1978;62:3-6.Crossref 19. Stroemland K: Malformations of the eyes . Acta Ophthalmol 1981;59:445-446. 20. Petersen RA, Walton DS: Optic nerve hypoplasia with good visual acuity and visual field defects . Arch Ophthalmol 1977;95:254-258.Crossref 21. Hoyt WF, Rios-Montenegro EN, Behrens MM, et al: Homonymous hemianoptic hypoplasia: Funduscopic features in standard red-free illumination in three patients with congenital hemiplegia . Br J Ophthalmol 1972;56:537-545.Crossref 22. Greenfield PS, Wilcox LM, Weiter JJ, et al: Hypoplasia of the optic nerve in association with porencephaly : J Pediatr Ophthalmol Strabismus 1980;17:75-78. 23. Jan JE, Robinson GC, Kinnis C, et al: Blindness due to optic-nerve atrophy and hypoplasia in children: An epidemiological study (1944-1974) . Dev Med Child Neurol 1977;19:353-363.Crossref 24. Lloyd L, Buncic JR: Hypoplasia in the optic nerve and disc , in Smith JL (ed): Neuro-ophthalmology Focus 1980 . New York, Masson, 1979, pp 85-96. 25. Layman PR, Anderson DR, Flynn JT: Frequent occurrence of hypoplastic optic disks in patients with aniridia . Am J Ophthalmol 1974;77:513-516. 26. Denslow GT, Simms M: Duane's retraction syndrome associated with optic nerve hypoplasia . J Pediatr Ophthalmol Strabismus 1980;17:26-28. 27. Kottow MH: Congenital malformations of the retinal vessels with primary optic nerve involvement . Ophthalmologica 1978;176:86-90.Crossref 28. Brown GC: Optic nerve hypoplasia and colobomatous defects . J Pediatr Ophthalmol Strabismus 1982;19:90-93. 29. Skarf B, Hoyt CS: Optic nerve hypoplasia in children . Arch Ophthalmol 1984;102:62-67.Crossref 30. Mosier MA, Lieberman MF, Green WR, et al: Hypoplasia of the optic nerve . Arch Ophthalmol 1978;96:1437-1442.Crossref 31. DeMorsier G: Etudes sur les dystrophies cranioencephaliques: III. Agenesie du septum lucidum avec malformation du tractus optique: La dysplasia septo-optique . Schweiz Arch Neurol Neurochir Psychiatr 1956;77:267-292. 32. Boniuk V, Ho PK: Ocular findings in anencephaly . Am J Ophthalmol 1979;88:613-617. 33. Michaud J, Mizrahi EM, Urich H: Agenesis of the vermis with fusion of the cerebellar hemispheres, septo-optic dysplasia and associated anomalies: Report of a case . Acta Neuropathol 1982;56:161-166.Crossref 34. Rogers GL, Brown D, Gray I, et al: Bilateral optic nerve hypoplasia associated with cerebral atrophy . J Pediatr Ophthalmol Strabismus 1981;18:18-22. 35. Collier PMM: Hemiatrophie faciale progressive, cyclite heterochromique de Fuchs et micropapille . Bull Soc Ophtalmol Fr 1967;67:595-603. 36. Goldhammer Y, Smith JL: Optic nerve anomalies in basal encephalocele . Arch Ophthalmol 1975;93:115-118.Crossref 37. Harcourt RB: Developmental abnormalities of the optic nerve . Trans Ophthalmol Soc UK 1976;96:395-398. 38. Rathbun JE, Hoyt WF, Beard C: Surgical management of orbitofrontal varix in Klippel-Trenaunay-Weber syndrome . Am J Ophthalmol 1970;70:109-112. 39. Terplan KL, Sandberg AA, Aceto T: Structural anomalies in the cerebellum in association with trisomy . JAMA 1966;197:557-568.Crossref 40. Garg BP: Colpocephaly: An error of morphogenesis? Arch Neurol 1982;39:243-246.Crossref 41. Chan CC, Egbert PR, Herrick MK, et al: Oculocerebral malformations: A reappraisal of Walker's lissencephaly . Arch Neurol 1980;37:104-108.Crossref 42. Macrae DW, Howard RO, Albert DM, et al: Ocular manifestations of the Meckel syndrome . Arch Ophthalmol 1972;88:106-113.Crossref 43. Clark EA, Meyer WF: Blindness and hypoglycemia: Growth hormone deficiency with septo-optic dysplasia . Tex Med 1978;74:47-50. 44. Hoyt WF, Kaplan SL, Grumbach MM, et al: Septo-optic dysplasia and pituitary dwarfism . Lancet 1970;1:893-894.Crossref 45. Kreibig W: Uber aplasie und hypoplasie der papilla nervi optici . Klin Monatsbl Augen-heilkd 1959;135:212-223. 46. Van Balen A, Santens P: Chondrodystrophica calcificans congenita . J Pediatr Ophthalmol Strabismus 1968;5:151-156. 47. Collier PMM: Dystostose mandibulofaciale et hypoplasie papillaire . Bull Soc Ophtalmol Fr 1961;11:873-879. 48. Huseman CA, Kelch RP, Hopwood NJ, et al: Sexual precocity associated with septo-optic dysplasia and hypothalamic hypopituitarism . J Pediatr 1978;92:748-753.Crossref 49. Margolis S, Slobodan A, Charles N, et al: Retinal and optic nerve findings in Goldenhar-Gorlin syndrome . Ophthalmology 1984;91:1327-1333.Crossref 50. Simpson JL, Elias S, Martin AO, et al: Diabetes in pregnancy, Northwestern University series (1977-1981) . Am J Obstet Gynecol 1983;146:263-270. 51. Soler NG, Walsh CH, Malins JM: Congenital malformations in infants of diabetic mothers . Q J Med 1976;45:303-313. 52. Soler NG, Soler S, Malins JM: Neonatal morbidity among infants of diabetic mothers . Diabetes Care 1978;1:340-353.Crossref 53. Kalter H, Warkany J: Congenital malformations: Etiologic factors and their role in prevention . N Engl J Med 1983;308:424-431.Crossref 54. Mills JL: Malformations in infants of diabetic mothers . Teratology 1982;25:385-394.Crossref 55. Ely JI: Hyperglycemia and major congenital anomalies . N Engl J Med 1981;305:833. 56. Naeve C, cited by Kitzmiller JL, Cloherty JP, Younger MD, et al: Diabetic pregnancy and perinatal morbidity . Am J Obstet Gynecol 1978;131:560-580. 57. Chung CS, Myrianthopoulos NC: Factors affecting risks of congenital malformations: II. Effect of maternal diabetes . Birth Defects 1975;11:23-37. 58. Bennett PH, Wehner C, Miller M: Congenital anomalies and the diabetic and prediabetic pregnancy . Ciba Found Symp 1979;63:207-225. 59. Donat JFG: Septo-optic dysplasia in an infant of a diabetic mother . Arch Neurol 1981;38:590-591.Crossref 60. Williamson DAJ: A syndrome of congenital malformations possibly due to maternal diabetes . Dev Med Child Neurol 1970;12:145-152.Crossref 61. Miller E, Hare JW, Cloherty JP, et al: Elevated maternal hemoglobin AIC in early pregnancy and major anomalies in infants of diabetic mothers . Teratology 1982;25:385-394.Crossref 62. Driscoll SG, Benirschke K, Curtis GW: Neonatal deaths among infants of diabetic mothers . AJDC 1960;100:818-835. 63. Gellis SS, Hsia DY: The infant of the diabetic mother . AJDC 1959;97:1-41. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Optic Nerve Hypoplasia and Maternal Diabetes Mellitus

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Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1986.00520010016013
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Abstract

Abstract • Altitudinal visual field defects were discovered in four young women on routine eye or general physical examinations. This led to extensive investigations because three of them were falsely presumed to have acquired disorders of the central nervous system. In each case the defect appeared to result from congenital hypoplasia of the optic nerve associated with maternal diabetes mellitus. Congenital optic nerve hypoplasia should be included in the differential diagnosis of visual field defects even when they are discovered in adults. Hypoplasia consequent to maternal diabetes mellitus is apt to be associated with excellent visual acuity and is usually an isolated defect. The female offspring of diabetic mothers may be at greater risk than the male offspring for the development of this anomaly. References 1. Traquair HM: The ocular manifestations of head injury . Trans Ophthalmol Soc UK 1929;49:348-358. 2. Schmidt D, Buhrmann K: Inferior hemianopsia in parasellar and pituitary tumors , in Glaser JS (ed): Neuro-ophthalmology . St Louis, CV Mosby Co, 1977, vol 9, pp 236-247. 3. Newman RP, Kinkel WR, Jacobs L: Altitudinal hemianopia caused by occipital infarctions . Arch Neurol 1984;41:413-421.Crossref 4. Teuber HL. Battersby WS, Bender MD: Visual Field Defects After Penetrating Missile Wounds of the Brain . Cambridge, Mass, Harvard University Press, 1960, pp 16-17. 5. Hotchkiss M, Green WR: Optic nerve aplasia and hypoplasia . J Pediatr Ophthalmol Strabismus 1979;16:225-240. 6. Acers TE: Optic nerve hypoplasia: Septooptic-pituitary dysplasia syndrome . Trans Am Ophthalmol Soc 1981;69:425-457. 7. Ellenberger C, Runyan TE: Holoprosen-cephaly with hypoplasia of the optic nerve, dwarfism and agenesis of the septum pellucidum . Am J Ophthalmol 1970;70:960-967. 8. Edwards WC, Layden WE: Optic nerve hypoplasia . Am J Ophthalmol 1970;70:950-959. 9. Walton DS, Robb RM: Optic nerve hypoplasia . Arch Ophthalmol 1970;84:572-578.Crossref 10. Bjork A, Laurell CG, Laurell U: Bilateral optic nerve hypoplasia with normal visual acuity . J Pediatr Ophthalmol Strabismus 1981;18:18-22. 11. VanDyk HJL, Morgan KS: Optic nerve hypoplasia and young maternal age . Am J Ophthalmol 1980;89:879. 12. Hittner AM, Desmond MM, Montgomery JR: Optic nerve manifestations of cytomegalus infection . Am J Ophthalmol 1976;81:661-665. 13. Taylor D: Congenital tumours of the anterior visual system with dysplasia of the optic discs . Br J Ophthalmol 1982;66:455-463.Crossref 14. Behrens MM: Other optic nerve diseases , in Lessell S, van Dalen JTW (eds): Neurol-ophthalmology . Amsterdam, Excerpta Medica, 1982, vol 2, pp 41-59. 15. Hackenbruch Y, Meerhoff E, Besio R, et al: Familial bilateral optic nerve hypoplasia . Am J Ophthalmol 1975;79:314-320. 16. McKinna AJ: Quinine-induced hypoplasia of the optic nerve . Can J Ophthalmol 1966;1:261-263. 17. Hoyt CS: Optic disc anomalies and maternal ingestion of LSD . J Pediatr Ophthalmol Strabismus 1978;15:286-289. 18. Hoyt CS, Billson FA: Maternal anticonvulsants and optic nerve hypoplasia . Br J Ophthalmol 1978;62:3-6.Crossref 19. Stroemland K: Malformations of the eyes . Acta Ophthalmol 1981;59:445-446. 20. Petersen RA, Walton DS: Optic nerve hypoplasia with good visual acuity and visual field defects . Arch Ophthalmol 1977;95:254-258.Crossref 21. Hoyt WF, Rios-Montenegro EN, Behrens MM, et al: Homonymous hemianoptic hypoplasia: Funduscopic features in standard red-free illumination in three patients with congenital hemiplegia . Br J Ophthalmol 1972;56:537-545.Crossref 22. Greenfield PS, Wilcox LM, Weiter JJ, et al: Hypoplasia of the optic nerve in association with porencephaly : J Pediatr Ophthalmol Strabismus 1980;17:75-78. 23. Jan JE, Robinson GC, Kinnis C, et al: Blindness due to optic-nerve atrophy and hypoplasia in children: An epidemiological study (1944-1974) . Dev Med Child Neurol 1977;19:353-363.Crossref 24. Lloyd L, Buncic JR: Hypoplasia in the optic nerve and disc , in Smith JL (ed): Neuro-ophthalmology Focus 1980 . New York, Masson, 1979, pp 85-96. 25. Layman PR, Anderson DR, Flynn JT: Frequent occurrence of hypoplastic optic disks in patients with aniridia . Am J Ophthalmol 1974;77:513-516. 26. Denslow GT, Simms M: Duane's retraction syndrome associated with optic nerve hypoplasia . J Pediatr Ophthalmol Strabismus 1980;17:26-28. 27. Kottow MH: Congenital malformations of the retinal vessels with primary optic nerve involvement . Ophthalmologica 1978;176:86-90.Crossref 28. Brown GC: Optic nerve hypoplasia and colobomatous defects . J Pediatr Ophthalmol Strabismus 1982;19:90-93. 29. Skarf B, Hoyt CS: Optic nerve hypoplasia in children . Arch Ophthalmol 1984;102:62-67.Crossref 30. Mosier MA, Lieberman MF, Green WR, et al: Hypoplasia of the optic nerve . Arch Ophthalmol 1978;96:1437-1442.Crossref 31. DeMorsier G: Etudes sur les dystrophies cranioencephaliques: III. Agenesie du septum lucidum avec malformation du tractus optique: La dysplasia septo-optique . Schweiz Arch Neurol Neurochir Psychiatr 1956;77:267-292. 32. Boniuk V, Ho PK: Ocular findings in anencephaly . Am J Ophthalmol 1979;88:613-617. 33. Michaud J, Mizrahi EM, Urich H: Agenesis of the vermis with fusion of the cerebellar hemispheres, septo-optic dysplasia and associated anomalies: Report of a case . Acta Neuropathol 1982;56:161-166.Crossref 34. Rogers GL, Brown D, Gray I, et al: Bilateral optic nerve hypoplasia associated with cerebral atrophy . J Pediatr Ophthalmol Strabismus 1981;18:18-22. 35. Collier PMM: Hemiatrophie faciale progressive, cyclite heterochromique de Fuchs et micropapille . Bull Soc Ophtalmol Fr 1967;67:595-603. 36. Goldhammer Y, Smith JL: Optic nerve anomalies in basal encephalocele . Arch Ophthalmol 1975;93:115-118.Crossref 37. Harcourt RB: Developmental abnormalities of the optic nerve . Trans Ophthalmol Soc UK 1976;96:395-398. 38. Rathbun JE, Hoyt WF, Beard C: Surgical management of orbitofrontal varix in Klippel-Trenaunay-Weber syndrome . Am J Ophthalmol 1970;70:109-112. 39. Terplan KL, Sandberg AA, Aceto T: Structural anomalies in the cerebellum in association with trisomy . JAMA 1966;197:557-568.Crossref 40. Garg BP: Colpocephaly: An error of morphogenesis? Arch Neurol 1982;39:243-246.Crossref 41. Chan CC, Egbert PR, Herrick MK, et al: Oculocerebral malformations: A reappraisal of Walker's lissencephaly . Arch Neurol 1980;37:104-108.Crossref 42. Macrae DW, Howard RO, Albert DM, et al: Ocular manifestations of the Meckel syndrome . Arch Ophthalmol 1972;88:106-113.Crossref 43. Clark EA, Meyer WF: Blindness and hypoglycemia: Growth hormone deficiency with septo-optic dysplasia . Tex Med 1978;74:47-50. 44. Hoyt WF, Kaplan SL, Grumbach MM, et al: Septo-optic dysplasia and pituitary dwarfism . Lancet 1970;1:893-894.Crossref 45. Kreibig W: Uber aplasie und hypoplasie der papilla nervi optici . Klin Monatsbl Augen-heilkd 1959;135:212-223. 46. Van Balen A, Santens P: Chondrodystrophica calcificans congenita . J Pediatr Ophthalmol Strabismus 1968;5:151-156. 47. Collier PMM: Dystostose mandibulofaciale et hypoplasie papillaire . Bull Soc Ophtalmol Fr 1961;11:873-879. 48. Huseman CA, Kelch RP, Hopwood NJ, et al: Sexual precocity associated with septo-optic dysplasia and hypothalamic hypopituitarism . J Pediatr 1978;92:748-753.Crossref 49. Margolis S, Slobodan A, Charles N, et al: Retinal and optic nerve findings in Goldenhar-Gorlin syndrome . Ophthalmology 1984;91:1327-1333.Crossref 50. Simpson JL, Elias S, Martin AO, et al: Diabetes in pregnancy, Northwestern University series (1977-1981) . Am J Obstet Gynecol 1983;146:263-270. 51. Soler NG, Walsh CH, Malins JM: Congenital malformations in infants of diabetic mothers . Q J Med 1976;45:303-313. 52. Soler NG, Soler S, Malins JM: Neonatal morbidity among infants of diabetic mothers . Diabetes Care 1978;1:340-353.Crossref 53. Kalter H, Warkany J: Congenital malformations: Etiologic factors and their role in prevention . N Engl J Med 1983;308:424-431.Crossref 54. Mills JL: Malformations in infants of diabetic mothers . Teratology 1982;25:385-394.Crossref 55. Ely JI: Hyperglycemia and major congenital anomalies . N Engl J Med 1981;305:833. 56. Naeve C, cited by Kitzmiller JL, Cloherty JP, Younger MD, et al: Diabetic pregnancy and perinatal morbidity . Am J Obstet Gynecol 1978;131:560-580. 57. Chung CS, Myrianthopoulos NC: Factors affecting risks of congenital malformations: II. Effect of maternal diabetes . Birth Defects 1975;11:23-37. 58. Bennett PH, Wehner C, Miller M: Congenital anomalies and the diabetic and prediabetic pregnancy . Ciba Found Symp 1979;63:207-225. 59. Donat JFG: Septo-optic dysplasia in an infant of a diabetic mother . Arch Neurol 1981;38:590-591.Crossref 60. Williamson DAJ: A syndrome of congenital malformations possibly due to maternal diabetes . Dev Med Child Neurol 1970;12:145-152.Crossref 61. Miller E, Hare JW, Cloherty JP, et al: Elevated maternal hemoglobin AIC in early pregnancy and major anomalies in infants of diabetic mothers . Teratology 1982;25:385-394.Crossref 62. Driscoll SG, Benirschke K, Curtis GW: Neonatal deaths among infants of diabetic mothers . AJDC 1960;100:818-835. 63. Gellis SS, Hsia DY: The infant of the diabetic mother . AJDC 1959;97:1-41.

Journal

Archives of NeurologyAmerican Medical Association

Published: Jan 1, 1986

References