Antiphospholipid syndrome manifesting as papilledema
- VernacularTitle:抗磷脂综合征表现为视乳头水肿1例
- Author:
Nadir A M ALI
;
I TAJUNISAH
;
V SUBRAYAN
;
S C REDDY
;
K J GOH
- Publication Type:Journal Article
- Keywords:
antiphospholipid syndrome;
superior sagittal sinus thrombosis;
papilledema;
acetazolamide;
sixth nerve palsy
- From:
International Eye Science
2007;7(6):1522-1525
- CountryChina
- Language:Chinese
-
Abstract:
·AIM: To report a rare case of antiphospholipid syndrome presenting as papilledema and sixth nerve palsy in right eye due to superior sagittal sinus thrombosis, and regression of papilledema following anticoagulation and acetazolamide therapy.·METHODS: A 44-year-old Chinese gentleman presented with headache, diplopia and mild blurring of vision. Clinical examination revealed the presence of sixth nerve palsy in right eye and papilledema. There was enlargement of blind spot in the visual fields and red green deficiency in both eyes.Computed tomography and magnetic resonance imaging showed superior sagittal sinus thrombosis. Hematological investigation confirmed the presence of antiphospholipid syndrome as the underlying cause.·RESULTS: The condition was treated successfully in three months with the adjunctive use of anticoagulation and acetazolamide. Reversal of papilledema changes in the optic disc to normal indicates the anatomical recovery, while reduction of enlargement of blind spot to normal size,recovery of red green deficieny to normal colour vision in both eyes and visual improvement after regression of papilledema in right eye indicate functional recovery in this patient.·CONCLUSION: Antiphospholipid syndrome should be considered in the differential diagnosis of papilledema, and oral acetazolamide is an important adjunct therapy to anticoagulation in cases of refractory papilledema to protect the optic nerve from potential damage which results in blindness.
