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OCT in a child with unilateral visual loss associated with post-papilledema optic atrophy Arisu Masuda 1 , Atsushi Miki 1 , Katsutoshi Goto 1 , Yumi Mito 1 , Yoshiaki Ieki 1 , Junichi Kiryu 1 1Departmant of Ophthalmology, Kawasaki Medical School pp.635-642
Published Date 2022/5/15
DOI https://doi.org/10.11477/mf.1410214381
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Abstract Purpose:The prognosis for visual function due to congestion of papillae is good, but prolonged increased intracranial pressure can lead to optic atrophy in both eyes. We report a case of optic atrophy after the papilledema that resulted in vision loss in only one eye.

Case:The case was a 9-year-old boy. Visual acuity was normal in both eyes when he had visited a nearby ophthalmologist in October 2019. In November, he suddenly began to blur when concentrating, and in February 2020, he visited a local ophthalmologist. The patient was referred to our department because of decreased visual acuity in the right eye and optic disc edema in both eyes. Visual acuity at first visit was 0.03 right, 1.2 left, 21 Hz right, and 40 Hz left with critical flicker frequency(CFF). OCT showed GCC thickness of 58.2/71.6 μm, cpRNFL thickness of unmeasurable/175.9 μm, and optic disc was edematous and slightly pale in both eyes. Head MRI showed falx meningioma, and optic disc edema was diagnosed as papilledema because the tumor did not compress the optic tract, including the optic nerve. Two weeks later, a craniotomy tumor was removed by neurosurgery. Four months after surgery, visual acuity improved to 0.05 right and 1.2 left;CFF improved to 36 Hz in both eyes, GCC thickness was 49.8/57.3 μm, cpRNFL thickness was 74.6/90.0 μm, and optic disc swelling was reduced in both eyes. After 5 months from the operation, visual acuity was 0.05 right and 1.2 left, GCC thickness was 48.3/56.2 μm, cpRNFL thickness was 68.6/79.3 μm, and optic disc became pale in both eyes.

Conclusion:Prognosis of optic atrophy after the papilledema might be different in this case by OCT.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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