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Papilledema with unusual ocular hemorrhages
Archives of Ophthalmology (Chicago, Ill. : 1960)
|February 1, 1981
Summary
Papilledema can cause vision-threatening retinal hemorrhages, including subhyaloid and vitreous bleeding. Differentiating these from other causes is crucial for appropriate patient management and treatment.
Area of Science:
- Ophthalmology
- Neurology
- Vascular Medicine
Background:
- Papilledema, or optic disc swelling, is a significant clinical sign.
- Retinal hemorrhages can occur in the posterior pole, subhyaloid space, and vitreous.
- The etiology of these hemorrhages requires careful differentiation.
Purpose of the Study:
- To investigate the occurrence and characteristics of retinal hemorrhages in patients with papilledema.
- To differentiate these hemorrhages from those caused by other conditions.
Main Methods:
- Retrospective analysis of 402 consecutive patients with papilledema.
- Clinical examination focusing on posterior pole, subhyaloid, and vitreous hemorrhages.
- Comparison with cases of subarachnoid bleeding, central retinal vein occlusion, and inflammation.
Main Results:
- Fourteen patients (4%) presented with posterior pole retinal hemorrhages or subhyaloid/vitreous bleeding.
- Subhyaloid/vitreous hemorrhage often resulted from peripapillary hemorrhage dissection.
- Posterior pole hemorrhages suggested central retinal vein compromise due to optic disc swelling.
Conclusions:
- Papilledema is associated with specific patterns of retinal hemorrhage.
- Clinical features like bilaterality, severity, and course help distinguish papilledema-related hemorrhages.
- These findings aid in differentiating papilledema-associated hemorrhages from other vascular events.