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Abstract：
BACKGROUND: Papilledema is the main ocular finding in patients with idiopathic intracranial hypertension (IIH) although several chorioretinal abnormalities may also occur and contribute to visual loss. The purpose of this paper is to describe two cases of chorioretinal abnormalities associated with idiopathic intracranial hypertension: one with choroidal folds and another with polypoidal choroidal vasculopathy, an extremely unusual ocular complication in the disease.
METHODS: Case 1: A 47-year-old woman previous diagnosed with idiopathic intracranial hypertension treated with weight loss and acetazolamide that over the following 6 months had optic disc edema gradually resolved. The patient was follow-up for a period of 10 years and the papilledema disappeared, but choroidal folds remained unchanged. Case 2: A 61-year-old female patient was seen as a follow-up examination of a 5-year history of IIH that presented with papilledema. The patient was asymptomatic but fundoscopy evaluation revealed a yellowish white peripapillary subretinal nodular lesion temporally in OD. Multimodal imaging studies were made, and the patient was diagnosed with a rare and just recent described association of IIH and polypoidal choroidal vasculopathy.
CONCLUSIONS: Papilledema, RNFL and retinal ganglion cell loss are the most common structural complications of IIH, but chorioretinal complications are important findings and should be carefully evaluated in such patients. Awareness of such occurrence and the use of appropriated clinical and multimodal imaging studies are of great importance for its early detection, leading to proper treatment and prevention of further visual loss.
METHODS: Case 1: A 47-year-old woman previous diagnosed with idiopathic intracranial hypertension treated with weight loss and acetazolamide that over the following 6 months had optic disc edema gradually resolved. The patient was follow-up for a period of 10 years and the papilledema disappeared, but choroidal folds remained unchanged. Case 2: A 61-year-old female patient was seen as a follow-up examination of a 5-year history of IIH that presented with papilledema. The patient was asymptomatic but fundoscopy evaluation revealed a yellowish white peripapillary subretinal nodular lesion temporally in OD. Multimodal imaging studies were made, and the patient was diagnosed with a rare and just recent described association of IIH and polypoidal choroidal vasculopathy.
CONCLUSIONS: Papilledema, RNFL and retinal ganglion cell loss are the most common structural complications of IIH, but chorioretinal complications are important findings and should be carefully evaluated in such patients. Awareness of such occurrence and the use of appropriated clinical and multimodal imaging studies are of great importance for its early detection, leading to proper treatment and prevention of further visual loss.
摘要：
背景：乳头水肿是特发性颅内高压（IIH）患者的主要眼部表现，尽管也可能发生几种脉络膜视网膜异常并导致视力丧失。本文的目的是描述两种与特发性颅内高压相关的脉络膜视网膜异常：一种是脉络膜褶皱，另一种是息肉状脉络膜血管病变，这种疾病中极其不寻常的眼部并发症。
方法：案例1：一名47岁女性，既往诊断为特发性颅内高压，接受体重减轻和乙酰唑胺治疗，在接下来的6个月内，视盘水肿逐渐消退。患者随访10年，乳头水肿消失，但脉络膜褶皱保持不变。病例2：一名61岁的女性患者被视为对5年IIH病史的随访检查，该病史表现为乳头水肿。该患者无症状，但眼底镜检查评估显示，在OD上有淡黄色白色的乳头旁视网膜下结节病变。进行了多模态成像研究，患者被诊断为罕见的，最近刚刚描述的IIH和息肉状脉络膜血管病变的关联。
结论：乳头水肿，RNFL和视网膜神经节细胞丢失是IIH最常见的结构性并发症，但是脉络膜视网膜并发症是重要的发现，应仔细评估此类患者。对此类发生的认识以及适当的临床和多模态成像研究的使用对于其早期发现非常重要。导致适当的治疗和预防进一步的视力丧失。
方法：案例1：一名47岁女性，既往诊断为特发性颅内高压，接受体重减轻和乙酰唑胺治疗，在接下来的6个月内，视盘水肿逐渐消退。患者随访10年，乳头水肿消失，但脉络膜褶皱保持不变。病例2：一名61岁的女性患者被视为对5年IIH病史的随访检查，该病史表现为乳头水肿。该患者无症状，但眼底镜检查评估显示，在OD上有淡黄色白色的乳头旁视网膜下结节病变。进行了多模态成像研究，患者被诊断为罕见的，最近刚刚描述的IIH和息肉状脉络膜血管病变的关联。
结论：乳头水肿，RNFL和视网膜神经节细胞丢失是IIH最常见的结构性并发症，但是脉络膜视网膜并发症是重要的发现，应仔细评估此类患者。对此类发生的认识以及适当的临床和多模态成像研究的使用对于其早期发现非常重要。导致适当的治疗和预防进一步的视力丧失。
