Article: article from journal or magazin.
Bilateral peripapillary subretinal neovessel membrane associated with chronic papilledema: report of two cases
Klinische Monatsblatter fur Augenheilkunde
Journal Article --- Old month value: Mar
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.
Adult Astrocytoma/*complications/diagnosis/surgery Brain Neoplasms/*complications/diagnosis/surgery Child Chronic Disease Diagnosis, Differential Fluorescein Angiography Follow-Up Studies Humans Hydrocephalus/*complications/diagnosis/surgery Intracranial Hypertension/*complications/diagnosis/surgery Male Optic Disk/*blood supply/pathology Papilledema/*complications/diagnosis/surgery Retinal Neovascularization/*complications/diagnosis Vision Disorders/diagnosis/*etiology/surgery Vision, Low/diagnosis/etiology Visual Acuity/physiology
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