A Case Report of a Young Male with Papillophlebitis

Abstract

Introduction: Papillophlebitis is a rare condition that may present clinically like an incomplete central retinal vein occlusion (CRVO). Papillophlebitis is a rare ocular condition that typically affects young (20-35 years old), previously healthy patient. Papillophlebitis can lead to ischemic CRVO with resulting macular edema and poor visual outcome. Aim: Aim of our case report is to present a rare case of a young male patient with papillophlebitis and to present the treatment that we gave to the patient with a good result. Case report: Patient AL male born 1986, came to our Clinic with sudden loss of vision on the right eye. First he had dark shadow in the right eye 15 days before he lost vision on the right eye. He was diagnosed with arterial hypertension. He does not have any previous medical history, but he had injury of the right eye 1993, he did not have surgery only local therapy and without any consequences. VOD: sc 2/60, VOS: sc 1.0, TOD: 16mmHg, TOS: 17mmHg. Slit lamp examination showed on the right fundus optic disc edema, retinal venous dilation and tortuousity, and intraretinal hemorrhages around optic disc and macula. Optical coherence tomography showed macular edema. Laboratory testing showed high concentration of coagulation factors: II,V, VII, IX, X, XII, and protein C. Immunology testing were negative. We treated him with high doses of intravenous methylprednisolone and we gave intravitreal bevacizumab in the right eye. He was discharged with significantly improved vision and local status on the right eye was better. Conclusion: We consider that the inflammatory reaction and reaction and the coagulation alternation present risk factors for the development of papillophlebitis. Also, we suggest that anti-VEGFs, with corticosteroids, are beneficial for treating papillophlebitis when visual acuity is decreased due to subretinal fluid.