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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Main Authors: 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.
Format: Digital revista
Language:English
Published: Conselho Brasileiro de Oftalmologia 2021
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492021000600598
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spelling 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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countrycode BR
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language English
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author 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.
spellingShingle 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.
publisher Conselho Brasileiro de Oftalmologia
publishDate 2021
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492021000600598
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