Journal article
Bilateral peripapillary subretinal neovessel membrane associated with chronic papilledema: report of two cases.
- Nguyen C Hôpital Ophtalmique Jules Gonin, University of Lausanne, Lausanne, Switzerland.
- Borruat FX
- 2005-03-24
Published in:
- Klinische Monatsblatter fur Augenheilkunde. - 2005
Adult
Astrocytoma
Brain Neoplasms
Child
Chronic Disease
Diagnosis, Differential
Fluorescein Angiography
Follow-Up Studies
Humans
Hydrocephalus
Intracranial Hypertension
Male
Optic Disk
Papilledema
Retinal Neovascularization
Vision Disorders
Vision, Low
Visual Acuity
English
BACKGROUND
Increased intracranial pressure (ICP) usually results in headaches and papilledema with infrequent loss of visual acuity. Peripapillary subretinal neovessel membranes (PSNVM) rarely complicate chronic papilledema.
HISTORY AND SIGNS
Case 1: A headache-free 9-year-old boy presented with a bilateral loss of vision due to chronic papilledema. Bilateral PSNVM was present. Cerebral imaging revealed a pilocytic astrocytoma and hydrocephaly. Case 2: A headache-free 39-year-old man presented with severe visual loss of the left eye due to an exudative macular star. Severe papilledema and PSNVM were present in both eyes due to idiopathic intracranial hypertension.
THERAPY AND OUTCOME
Lowering of ICP (tumor resection - Case 1 and lumboperitoneal shunt - Case 2) resulted in involution of the PSNVMs in both patients. No improvement of visual acuity occurred for Case 1 (optic atrophy) but Case 2 benefited from gradual visual recovery.
CONCLUSIONS
PSNVMs are rare complications of chronic papilledema, as only 10 patients have been reported so far in the literature. Absence of headaches in both of our patients was probably responsible for the late diagnosis, hence chronicity of papilledema. Laser therapy of PSNVM might not be necessary once the ICP is lowered.
Increased intracranial pressure (ICP) usually results in headaches and papilledema with infrequent loss of visual acuity. Peripapillary subretinal neovessel membranes (PSNVM) rarely complicate chronic papilledema.
HISTORY AND SIGNS
Case 1: A headache-free 9-year-old boy presented with a bilateral loss of vision due to chronic papilledema. Bilateral PSNVM was present. Cerebral imaging revealed a pilocytic astrocytoma and hydrocephaly. Case 2: A headache-free 39-year-old man presented with severe visual loss of the left eye due to an exudative macular star. Severe papilledema and PSNVM were present in both eyes due to idiopathic intracranial hypertension.
THERAPY AND OUTCOME
Lowering of ICP (tumor resection - Case 1 and lumboperitoneal shunt - Case 2) resulted in involution of the PSNVMs in both patients. No improvement of visual acuity occurred for Case 1 (optic atrophy) but Case 2 benefited from gradual visual recovery.
CONCLUSIONS
PSNVMs are rare complications of chronic papilledema, as only 10 patients have been reported so far in the literature. Absence of headaches in both of our patients was probably responsible for the late diagnosis, hence chronicity of papilledema. Laser therapy of PSNVM might not be necessary once the ICP is lowered.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1055/s-2005-857981
- PMID 15786000
- Persistent URL
- https://sonar.ch/global/documents/93777
Statistics
Document views: 37
File downloads: