First Author: A.Rossello Ferrer SPAIN
Co Author(s): A. Garrido Hermosilla M. Diaz Granda
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To provide objective measures of foveal avascular zone (FAZ) by optical coherence tomography angiography (OCT-A) and correlate them with other macular swept-source OCT (SS OCT) findings during the follow-up of a patient with papilledema due to secondary intracranial hypertension.
Retina Unit, Ophthalmology Department, Virgin Macarena University Hospital (Seville, Spain). RETICS OftaRed, Institute of Health Carlos III (Madrid, Spain).
A 23-year-old woman was admitted to our hospital because of headache, diplopia and bilateral papilledema. She was diagnosed with idiopathic intracranial hypertension, being treated with several lumbar punctures, acetazolamide and topiramate. Right internal jugular vein thrombosis was found in magnetic resonance angiography, so oral contraceptive pills were interrupted and genetic tests were performed, revealing a MTHFR mutation. Symptoms disappeared after acenocoumarol was started, including diplopia.
Visual acuity remained stable (20/20) during all the follow-up, although there was a reduction of contrast sensitivity. Papilledema and retinal distortion in SS OCT were fully recovered after 6 months. Ganglionar cell layer thickness was not affected and regular visual fields showed mild loss. Surprisingly, there was an enlargement of superficial and deep FAZ in OCT-A.
FAZ enlargement, mainly the deep one, could be an important finding in patients affected by papilledema. Its physiopathological mechanism is still unknown: ischaemia and inflammatory cytokines could be involved in. More studies are needed in order to determine its prognostic value.