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Severe sudden visual loss caused by pseudotumor cerebri and lumboperitoneal shunt failure
G T Liu1, N J Volpe, N J Schatz
1Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA. gliu@mail.med.upenn.edu
Purpose:
Severe vistral acuity loss associated with pseudotumor cerebri is usually caused by chronic optic disk edema or a retinal abnormality.
Methods:
We treated a women, with known pseudotumor cerebri treated with a lumboperitoneal shunt, who developed acute pallied optic disk swelling and visual acuity of R.E.: no light perception and L.E.: 20/70 in association with lumboperitoneal shunt failure. There were no contributory retinal lesions.
Results:
The patient underwent optic nerve sheath fenestration and lumboperitoneal shunt revision. Visual acuity improved to 20/20 in both eyes. The papilledema resolved.
Conclusion:
The severe sudden visual loss was attributed to axoplasmic stasis and optic nerve ischemia associated with a sudden rise in intracranial pressure.