A teenage girl newly diagnosed with idiopathic intracranial hypertension by her neurologist presented with 2 weeks of headaches, dizziness, and blurred vision. Her best-corrected visual acuity was 20/25 OD and 20/20 OS. There was no afferent pupillary defect, her Ishihara color plate findings were 10/10, and extraocular movements were intact in both eyes. An anterior slitlamp examination had unremarkable findings. A fundus examination showed hemorrhagic optic disc edema, peripapillary and subfoveal subretinal fluid, tortuous and dilated retinal vasculature, many intraretinal hemorrhages in all 4 quadrants, and far peripheral temporal inner retinal whitening in both eyes (Figure 1A). Optical coherence tomography demonstrated peripapillary and subfoveal subretinal fluid, intraretinal fluid, and swollen optic nerve heads in both eyes (Figure 1B). A fluorescein angiogram showed markedly delayed venous filling (1 minute) in all quadrants and far peripheral capillary nonperfusion in both eyes.
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Michalak SM, Meekins LC, Ali MH. Optic Nerve Edema, Venous Stasis Retinopathy, and Peripheral Retinal Whitening in a Teenage Girl. JAMA Ophthalmol. 2020;138(10):1087–1088. doi:10.1001/jamaophthalmol.2020.1398
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