Presentation and Progression of Papilledema in Cerebral Venous Sinus Thrombosis
| Autor: | Michael S. Lee, Rod Foroozan, Zoë R. Williams, Katy C. Liu, Courtney E. Francis, Aaron M. Fairbanks, Celine E. Satija, John J. Chen, M. Tariq Bhatti, Mays A. El-Dairi, Michael T. Wildes, Prem S. Subramanian, Collin M. McClelland |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual acuity Time Factors Adolescent Vision Disorders Visual Acuity Ophthalmoscopy 03 medical and health sciences Sinus Thrombosis Intracranial Young Adult 0302 clinical medicine Risk Factors medicine Humans Cerebral venous sinus thrombosis Young adult Papilledema Child 030304 developmental biology Aged Retrospective Studies 0303 health sciences medicine.diagnostic_test business.industry Retrospective cohort study Odds ratio Middle Aged medicine.disease eye diseases Visual field Ophthalmology 030221 ophthalmology & optometry Disease Progression Visual Field Tests Female Radiology medicine.symptom Visual Fields business |
| Zdroj: | American journal of ophthalmology. 213 |
| ISSN: | 1879-1891 |
| Popis: | To determine the natural history and visual outcomes of papilledema in cerebral venous sinus thrombosis (CVST).Retrospective observational case series.This multicenter study included 7 tertiary care neuro-ophthalmology clinics. Sixty-five patients with CVST were identified who received serial eye examinations with documented papilledema from 2008-2016. Outcome measures included time from diagnosis to papilledema documentation, papilledema progression, time to papilledema resolution, treatment interventions and final visual outcomes.Papilledema was present on initial presentation in 54% of patients or detected later during the course of the disease in 46% of patients. The average time from CVST diagnosis to papilledema documentation was 29 days with a mean (SD) initial Frisén grade of 2.7 (1.3). In 21.5% of cases, papilledema progressed over an average of 55.6 (56.6) days. Time to papilledema resolution was approximately 6 months. Final visual acuity ranged from 20/20 to light perception, with 40% of patients having residual visual field defects on standard automated perimetry. Frisén grade ≥3 (odds ratio [OR] 10.21, P.0053) and cases with worsening papilledema (3.5, P.043) were associated with permanent visual field deficits.Our study indicates the importance of serial ophthalmic evaluation in all cases of CVST. Follow-up fundoscopy is critical given that a subset of cases can show delayed onset and/or worsening of papilledema with time. Specifically, we recommend an ophthalmic examination at the time of initial diagnosis, with repeat examination within a few weeks and further follow-up depending on the level of papilledema or vision changes. |
| Databáze: | OpenAIRE |
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