Coexistence of papilledema and pseudopapilledema after remission of idiopathic intracranial hypertension by bariatric surgery

• Published in: Arquivos brasileiros de oftalmologia Vol. 83; no. 2; pp. 157 - 159
• Main Authors: Simão, Luciano Mesquita, Andrade, Thaís Nunes, Oliveira, Ana Flávia Alves de Oliveira E, Garcez, Andressa Guimarães Aguilar, Jacometti, Raíza
• Format: Journal Article
• Language: English
• Published: Brazil Conselho Brasileiro de Oftalmologia 01.03.2020
• Subjects: Adult; Bariatric Surgery - adverse effects; Eye Diseases, Hereditary - diagnostic imaging; Eye Diseases, Hereditary - etiology; Female; Humans; Magnetic Resonance Imaging; OPHTHALMOLOGY; Optic Disk Drusen - complications; Optic Disk Drusen - diagnostic imaging; Optic Nerve Diseases - diagnostic imaging; Optic Nerve Diseases - etiology; Papilledema - diagnostic imaging; Papilledema - etiology; Pseudotumor Cerebri - diagnostic imaging; Pseudotumor Cerebri - physiopathology; Syndrome; Visual Field Tests; Hipertensão intracraniana; Papiledema; Humanos; Imagem por ressonância magnética; Intracranial hypertension; Humans; Bariatric surgery; Drusas do disco óptico; Case reports; Relatos de casos; Papilledema; Cirurgia bariátrica; Magnetic resonance imaging; Optic disk drusen
• ISSN: 0004-2749; 1678-2925; 1678-2925
• 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.