[Skip to Navigation]
Views 1,779
Citations 0
JAMA Ophthalmology Clinical Challenge
August 6, 2020

Optic Nerve Edema, Venous Stasis Retinopathy, and Peripheral Retinal Whitening in a Teenage Girl

Author Affiliations
  • 1Duke Eye Center, Department of Ophthalmology, Duke University, Durham, North Carolina
  • 2The Retina Group of Washington, Sterling, Virginia
JAMA Ophthalmol. 2020;138(10):1087-1088. doi:10.1001/jamaophthalmol.2020.1398

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.

Limit 200 characters
Limit 25 characters
Conflicts of Interest Disclosure

Identify all potential conflicts of interest that might be relevant to your comment.

Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.

Err on the side of full disclosure.

If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.

Not all submitted comments are published. Please see our commenting policy for details.

Limit 140 characters
Limit 3600 characters or approximately 600 words