Abstract

P 168

Unilateral papilledema as a sign of idiopathic increased intracraniel hypertension – Case report and review of literature

Stefanie Tech, Christina Gerth
Universitäts-Augenklinik Rostock

Objective
The most common sign of idiopathic increased intracraniel hypertension (IIH) is a bilateral and symmetric papilledema associated with retained visual acuity (VA). Unilateral papilledema is a diagnostic neuroophthalmological challenge.
Methods
Retrospective case report and review of literature
Results
A 48 year old woman with unilateral reduced contrast since 2 weeks without associated headaches demonstrated a papilledema in the affected eye but normal VA and color vision. Central visual field showed an enlarged blind spot. The diagnosis of IIH was made based on a normal cerebral MRI but increased opening pressure on lumbar puncture. Papilledema and visual disturbances were resolved after a 10 weeks therapy with oral carboanhydrase inhibitor. Literature review revealed that a unilateral papilledema is a rare sign of IIH. (Huna-Baron et al., Neurology 2001)
Conclusions
Based on the case report and the literature review, we emphasize that isolated unilateral papilledema without signs of a vascular or inflammatory causes need to be investigated by lumbar puncture with opening pressure measurement in cases of normal MRI. The outcome of IIH with unilateral papilledema is similar to those with bilateral papilledema as indicated by the literature review.

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