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Bilateral papilledema in idiopathic intracranial hypertension: a case report

Anak Agung Dewi Adnya Swari , Anak Agung Putri Satwika, Putu Nanda Tediantini, Anak Agung Mas Putrawati Triningrat

Anak Agung Dewi Adnya Swari
Department of Ophthalmology,Ramata Eye Hospital, Denpasar. Email: dewiadnya@gmail.com

Anak Agung Putri Satwika
Department of Ophthalmology,Ramata Eye Hospital, Denpasar

Putu Nanda Tediantini
Department of Ophthalmology,Ramata Eye Hospital, Denpasar

Anak Agung Mas Putrawati Triningrat
Department of Ophthalmology,Ramata Eye Hospital, Denpasar
Online First: December 15, 2020 | Cite this Article
Swari, A., Satwika, A., Tediantini, P., Triningrat, A. 2020. Bilateral papilledema in idiopathic intracranial hypertension: a case report. Bali Journal of Ophthalmology 4(2). DOI:10.15562/bjo.v4i2.82


Introduction: Idiopathic intracranial hypertension (IIH) or known as pseudo tumor cerebri is a challenging condition with raised intracranial pressure (ICP) in the absence of an identifiable cause. IIH occurs predominantly in women, and it has a striking association with obesity. The majority of patients presenting with IIH have symptoms that include a headache and visual disturbances. IIH presents challenges in management. This case report aims to discuss the clinical signs and management of idiopathic intracranial hypertension.

Case Report: A female 21 years old presented with visual field disturbances complaints since one week before admitted to the Hospital. Her symptom progressively worsened over time with headaches. Blood pressure was 150/80 mmHg, body weight was 110 kg, height was 167 cm, and body mass index was 40 kg/m2. Visual acuity in both eyes was 6/6. The intraocular pressure was 17 mmHg on the right eye and 18 mmHg on the left eye. There was a constriction of vision’s peripheral field and enlarged blind spot with Humphrey 24-2 visual field test. Fundus examination with optical coherence tomography of retinal nerve fiber layer revealed bilateral papilledema. The patient was diagnosed with papilledema et causa Idiopathic Intracranial Hypertension in both eyes. The patient was treated with acetazolamide and combination therapy with the neurology department.

Conclusion: IIH is a challenging disease with a collaborative department. Early and aggressive management is required to prevent irreversible visual impairment.

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