Optic nerve disc veins inflammation (papillophlebitis) - case report

Area of Science:

• Ophthalmology
• Neurology
• Dentistry

Background:

• Papillophlebitis is a rare condition affecting the optic nerve head.
• Early diagnosis and interdisciplinary management are crucial for favorable outcomes.

Observation:

• A 29-year-old patient presented with atypical orbital pain and flashing lights.
• Ophthalmoscopic examination revealed characteristic fundus changes and a large blind spot on perimetry.
• A relative afferent pupillary defect was noted, indicating optic nerve dysfunction.

Findings:

• Diagnostic workup excluded systemic causes like hypertension, diabetes, and coagulation disorders.
• Periodontal inflammation and sinus jaw changes were identified as the likely source of the inflammatory process.
• Treatment targeting the periodontal and sinus inflammation led to remission of papillophlebitis.

Implications:

• This case underscores the importance of considering dental and sinus infections in the differential diagnosis of optic nerve disorders.
• An interdisciplinary approach is vital for managing uncommon conditions like papillophlebitis.
• Prompt identification and treatment of underlying inflammatory sources can prevent vision loss.