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Disk edema in an overweight woman
1Department of Ophthalmology, University of South Carolina, School of Medicine, Columbia, USA.
Survey of Ophthalmology
|January 1, 1995
Summary
A patient with obesity experienced vision problems and lethargy due to Pickwickian syndrome and obstructive sleep apnea. Treating the sleep apnea resolved her symptoms, avoiding invasive procedures.
Area of Science:
- Neurology
- Ophthalmology
- Pulmonology
Background:
- Obesity can lead to various health complications, including those affecting vision and neurological function.
- Elevated intracranial pressure can manifest with symptoms like headaches and visual disturbances.
Observation:
- A 46-year-old obese woman presented with severe papilledema, visual obscurations, headaches, and lethargy.
- Initial presentation mimicked pseudotumor cerebri, but atypical symptoms like lethargy and retinal hemorrhages were noted.
Findings:
- The patient was diagnosed with Pickwickian syndrome, characterized by hypoxia, hypercapnia, and obstructive sleep apnea.
- Elevated serum bicarbonate levels indicated respiratory compromise.
Implications:
- Obstructive sleep apnea can cause significant neurological and ophthalmological symptoms mimicking other conditions.
- Effective treatment of obstructive sleep apnea can lead to rapid and dramatic improvement in associated symptoms.
- This case highlights the importance of considering sleep-disordered breathing in patients with unexplained papilledema and neurological signs.