Simão Luciano Mesquita, Andrade Thaís Nunes, Oliveira Ana Flávia Alves de Oliveira E, Garcez Andressa Guimarães Aguilar, Jacometti Raíza
Serviço de Neuro-Oftalmologia, Instituto de Olhos, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil.
Instituto de Olhos, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil.
Arq Bras Oftalmol. 2020 Mar-Apr;83(2):157-159. doi: 10.5935/0004-2749.20200030.
A 37-year-old woman complained of headaches following bilateral visual loss in the past two years. She was obese and had undergone bariatric surgery three months earlier, followed by a considerable weight loss. Neuro-ophthalmic examination revealed a bilateral swollen optic disk. After a computerized analysis of the visual fields and magnetic resonance imaging of the brain and orbits, a diagnosis of idiopathic intracranial hypertension was made. At six months after the bariatric surgery, the patient reported no further headaches and exhibited better findings on computerized analysis of visual fields. However, fundus examination revealed persistent mild papilledema in both eyes. Ocular B-scan ultrasonography showed bilateral optic disk drusen. This report highlights the coexistence of true papilledema and pseudopapilledema due to optic disk drusen, following remission of idiopathic intracranial hypertension after a bariatric surgery.
一名37岁女性在过去两年中双侧视力丧失后出现头痛症状。她体型肥胖,三个月前接受了减肥手术,术后体重显著减轻。神经眼科检查发现双侧视盘肿胀。经视野计算机分析以及脑部和眼眶磁共振成像检查后,诊断为特发性颅内高压。减肥手术六个月后,患者报告不再头痛,视野计算机分析结果也有所改善。然而,眼底检查显示双眼仍有持续性轻度视乳头水肿。眼部B超检查显示双侧视盘玻璃膜疣。本报告强调了减肥手术后特发性颅内高压缓解后,真正的视乳头水肿与视盘玻璃膜疣所致假性视乳头水肿并存的情况。