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JAMA Ophthalmology Clinical Challenge
February 28, 2019

Bilateral Papilledema and Partially Empty Sella in a Woman in Her 30s

Author Affiliations
  • 1State Key Laboratory of Ophthalmology, Image Reading Center, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
JAMA Ophthalmol. 2019;137(5):577-578. doi:10.1001/jamaophthalmol.2018.6948

A woman in her 30s was referred for evaluation of bilateral papilledema and progressive visual loss in the right eye, which deteriorated to blindness in 3 months. She denied any other neurologic symptoms, such as headache, nausea, vomiting, seizures, and paresis. She had a 4-year history of Behçet disease (BD), and her condition had been stabilized with thalidomide. Her optic neuropathy of BD had been treated with high-dose intravenous methylprednisolone for 4 days followed by oral prednisone for a month without improvement.