[A case of pseudotumor cerebri with improvement of vision after lumboperitoneal shunt]

Patients with pseudotumor cerebri, also called benign intracranial hypertension, generally have a favorable prognosis. However, this disorder can cause permanent, severe visual loss. To our knowledge, no reports have described in detail retinal damage resulting from pseudotumor cerebri.

We report the case of a 26-year-old woman who presented with serious bilateral visual impairment, severe papilledema, and retinal edema in a wide area. She was diagnosed with pseudotumor cerebri. Because of her progressive visual loss and failed medical control, she underwent a lumboperitoneal shunt. After the operation, her visual acuity and visual field improved in her left eye and the retinal edema resolved, but residual pigment epithelial damage was observed. In the first-order component of multifocal electroretinogram, the amplitudes were reduced, and peak implicit times were prolonged in the nasal retina.

Retinal damage caused by severe and long-standing retinal edema may contribute to the pathological mechanisms for visual loss as well as optic nerve damage. The course of visual function in our case was important for diagnosis and therapeutic decisions. Because a poor visual outcome may result from pseudotumor cerebri, an ophthalmologist should closely monitor visual loss and visual function.