Unilateral papilledema and peripapillary polypoidal choroidal vasculopathy as the presenting manifestations of intracranial hypertension
ABSTRACT We have reported here the case of a 54-year-old woman with intracranial hypertension that presented with the unique features of unilateral papilledema and peripapillary polypoidal choroidal vasculopathy. Our investigations lead to the diagnosis of idiopathic intracranial hypertension and an incidental small right frontal meningioma. The patient was accordingly treated with oral acetazolamide, followed by three consecutive monthly intravitreal injections of bevacizumab, which resulted in the inactivation of the polypoidal choroidal vasculopathy, marked reduction of lipid exudation, and complete absorption of the subretinal fluid. This case serves as the first documentation of polypoidal choroidal vasculopathy associated with papilledema. It also demonstrates that choroidal vascular abnormalities may occur even when optic disk edema is unilateral, which is an uncommon manifestation of increased intracranial pressure. Prompt recognition of such findings and its appropriate management are essential for adequate treatment and prevention of irreversible visual loss.
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Conselho Brasileiro de Oftalmologia
2021
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oai:scielo:S0004-274920210006005982021-11-18Unilateral papilledema and peripapillary polypoidal choroidal vasculopathy as the presenting manifestations of intracranial hypertensionMatos,Aline Mota FreitasCunha,Leonardo ProvettiSuzuki,Ana Cláudia F.Mello,Luiz Guilherme MarchesiPreti,Rony C.Zacharias,Leandro C.Monteiro,Mário L. R. Meningioma Choroidal neovascularization Papilledema Pseudotumor cerebri Vision disorder ABSTRACT We have reported here the case of a 54-year-old woman with intracranial hypertension that presented with the unique features of unilateral papilledema and peripapillary polypoidal choroidal vasculopathy. Our investigations lead to the diagnosis of idiopathic intracranial hypertension and an incidental small right frontal meningioma. The patient was accordingly treated with oral acetazolamide, followed by three consecutive monthly intravitreal injections of bevacizumab, which resulted in the inactivation of the polypoidal choroidal vasculopathy, marked reduction of lipid exudation, and complete absorption of the subretinal fluid. This case serves as the first documentation of polypoidal choroidal vasculopathy associated with papilledema. It also demonstrates that choroidal vascular abnormalities may occur even when optic disk edema is unilateral, which is an uncommon manifestation of increased intracranial pressure. Prompt recognition of such findings and its appropriate management are essential for adequate treatment and prevention of irreversible visual loss.info:eu-repo/semantics/openAccessConselho Brasileiro de OftalmologiaArquivos Brasileiros de Oftalmologia v.84 n.6 20212021-12-01info:eu-repo/semantics/othertext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492021000600598en10.5935/0004-2749.20210098 |
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Matos,Aline Mota Freitas Cunha,Leonardo Provetti Suzuki,Ana Cláudia F. Mello,Luiz Guilherme Marchesi Preti,Rony C. Zacharias,Leandro C. Monteiro,Mário L. R. |
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Matos,Aline Mota Freitas Cunha,Leonardo Provetti Suzuki,Ana Cláudia F. Mello,Luiz Guilherme Marchesi Preti,Rony C. Zacharias,Leandro C. Monteiro,Mário L. R. Unilateral papilledema and peripapillary polypoidal choroidal vasculopathy as the presenting manifestations of intracranial hypertension |
author_facet |
Matos,Aline Mota Freitas Cunha,Leonardo Provetti Suzuki,Ana Cláudia F. Mello,Luiz Guilherme Marchesi Preti,Rony C. Zacharias,Leandro C. Monteiro,Mário L. R. |
author_sort |
Matos,Aline Mota Freitas |
title |
Unilateral papilledema and peripapillary polypoidal choroidal vasculopathy as the presenting manifestations of intracranial hypertension |
title_short |
Unilateral papilledema and peripapillary polypoidal choroidal vasculopathy as the presenting manifestations of intracranial hypertension |
title_full |
Unilateral papilledema and peripapillary polypoidal choroidal vasculopathy as the presenting manifestations of intracranial hypertension |
title_fullStr |
Unilateral papilledema and peripapillary polypoidal choroidal vasculopathy as the presenting manifestations of intracranial hypertension |
title_full_unstemmed |
Unilateral papilledema and peripapillary polypoidal choroidal vasculopathy as the presenting manifestations of intracranial hypertension |
title_sort |
unilateral papilledema and peripapillary polypoidal choroidal vasculopathy as the presenting manifestations of intracranial hypertension |
description |
ABSTRACT We have reported here the case of a 54-year-old woman with intracranial hypertension that presented with the unique features of unilateral papilledema and peripapillary polypoidal choroidal vasculopathy. Our investigations lead to the diagnosis of idiopathic intracranial hypertension and an incidental small right frontal meningioma. The patient was accordingly treated with oral acetazolamide, followed by three consecutive monthly intravitreal injections of bevacizumab, which resulted in the inactivation of the polypoidal choroidal vasculopathy, marked reduction of lipid exudation, and complete absorption of the subretinal fluid. This case serves as the first documentation of polypoidal choroidal vasculopathy associated with papilledema. It also demonstrates that choroidal vascular abnormalities may occur even when optic disk edema is unilateral, which is an uncommon manifestation of increased intracranial pressure. Prompt recognition of such findings and its appropriate management are essential for adequate treatment and prevention of irreversible visual loss. |
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Conselho Brasileiro de Oftalmologia |
publishDate |
2021 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492021000600598 |
work_keys_str_mv |
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