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Papilledema with Cerebral Venous Sinus Thrombosis
정맥동 혈전증에 의한 시신경유두부종
JKOS 2019 Jun;60(6):606-11
Published online June 15, 2019;  https://doi.org/10.3341/jkos.2019.60.6.606
Copyright © 2019 The Korean Ophthalmological Society.
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Min Su Baek, MD, Sung Eun Kyung, MD, PhD
백민수·경성은

Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea
단국대학교 의과대학 안과학교실
Received August 8, 2018; Revised October 29, 2018; Accepted May 17, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: We report two patients diagnosed with a sinus thrombosis with papillary edema.
Case summary: Case 1 was a 27-year-old male who presented with complaints of headache and vomiting for 2 months and blurred vision in both eyes. The best-corrected visual acuity (BCVA) was 1.0 in the right eye and 1.0 in the left eye. A visual field (VF) examination revealed a binocular peripheral VF defect and optical coherence tomography (OCT) and a fundus examination indicated optic disc swelling in both eyes. Brain magnetic resonance imaging (MRI) showed no specific finding but magnetic resonance venography revealed filling defect signs in the transverse sinus and a cerebrospinal fluid examination indicated elevated intracranial pressure (ICP). Case 2 was a 54-year-old female who came to our hospital with suspicion of bilateral optic disc swelling. The BCVA was 0.9 in the right eye and 1.0 in the left eye. A VF examination revealed an inferior-temporal VF defect and blind spot enlargement in the right eye. OCT and a fundus examination showed optic disc swelling in both eyes. Brain MRI showed no specific finding but magnetic resonance venography revealed a decrease in blood flow in the transverse sinus, sigmoid sinus. A cerebrospinal fluid examination indicated elevated ICP.
Conclusions: In the case of optic disc swelling in both eyes, a secondary cause of ICP elevation and the possibility of optic disc swelling due to sinus thrombosis should be considered, and brain MRI and venography are needed to distinguish these possibilities.
Keywords : Optic neuropathy, Papilledema, Venous sinus thrombosis

 

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