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Papilledema as a diagnostic challenge — report of three cases

  • Case Report
  • Published:
Central European Journal of Medicine

Abstract

We present three different cases of patients with papilledema: one case with a primary tumour of the optic nerve, and two cases with secondary involvement of the optic nerve (breast carcinoma and non-Hodgkin lymphoma). The visual acuity varies from sudden, painless, decrease of vision, to blurred vision and proptosis on the affected eye. A characteristic ophthalmoscopic examination shows a swollen optic disc and promonence with tortuosity of blood vessels. A fluorescein angiography shows dilated capillaries of the optic disc with leakage in the early phase and diffuse hyperfluorescence during the late phase. A ultrasonography B-scan of the affected eye shows prominent optic nerves with widened optic nerve sheath. An exhaustive history and complete ophthalmological examination are essential for the diagnosis, to which fluorescein angiography, B-scan ultrasonography, ocular coherent tomography, computerized tomography, and magnetic resonance can be used as useful additional tests. Treatment and prognosis depend on the primary process. We emphasize the crucial role of ophthalmologist in the early diagnosis of CNS neoplasia.

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Abbreviations

ONSM:

optic nerve sheath meningeoma

FA:

fluorescein angiography

OCT:

ocular coherent tomography

USG:

ultrasonography

CT:

computed tomography

MRI:

magnetic resonance

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Author information

Authors and Affiliations

  1. Department for Retinal Disorders, Eye Clinic, Clinic Centre Niš, Bulevar Dr Zorana Đinđića 48, 18000, Niš, Serbia

    Sonja Cekić

  2. Department for Retinal Disorders, Institute for Eye Diseases, Faculty of Medicine, Dr Subotića 8 Street, 11 000, Belgrade, Serbia

    Dijana Risimić

  3. Eye Clinic, Faculty of Medicine, University of Niš, Bulevar Dr Zorana Đinđića 48, 18000, Niš, Serbia

    Gordana Stanković-Babić & Jasmina Đorđević-Jocić

  4. Centar for Radiology, Clinic Centre Niš, Bulevar Dr Zorana Đinđića 48, 18000, Niš, Serbia

    Rade Babić

  5. Department of Ophthalmology, Faculty of Medicine, Kosovska Mitrovica, Serbia

    Vesna Jakšić

  6. Department of Anatomy, Faculty of Medicine, University of Niš, Bulevar Dr Zorana Đinđića 81, 18000, Niš, Serbia

    Ivan Jovanović

Authors
  1. Sonja Cekić
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  2. Dijana Risimić
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  3. Gordana Stanković-Babić
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  4. Rade Babić
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  5. Vesna Jakšić
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  6. Ivan Jovanović
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  7. Jasmina Đorđević-Jocić
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Correspondence to Sonja Cekić.

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Cekić, S., Risimić, D., Stanković-Babić, G. et al. Papilledema as a diagnostic challenge — report of three cases. cent.eur.j.med 7, 100–107 (2012). https://doi.org/10.2478/s11536-011-0112-3

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  • DOI: https://doi.org/10.2478/s11536-011-0112-3

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