Subretinal haemorrhage in idiopathic intracranial hypertension

McCASLAND, Barry J; Mendicino, Maria E.; Newman, Nancy J.

doi:10.1136/bjo.83.7.878g

Cited by 9 publications

(4 citation statements)

References 4 publications

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“…Periorbital ecchymosis due to an increase in the orbital venous hypertension whether transient or prolonged has been reported in association with intracranial pathologies such dural sinus thrombosis1; superior sagittal sinus thrombosis2; cavernous sinus thrombosis3; idiopathic intracranial hypertension4; migraine due to combination of the vasodilation and the release of the vasoactive substances including heparin during acute attack5 6; trigeminal autonomic cephalgia7 with other features such as headache, rhinorrhoea, nasal congestion, palpebral oedema, labile hypertension and behavioural abnormalities, neuroblastoma8 9 with metastasis involving the base of the skull has caused an obstruction of the palpebral vessels which are branches of the ophthalmic and facial vessels; or extracranial diseases such as vomiting in our case, severe cough in bronchial asthma10 will produce a valsalva manoeuvre and an increase in the venous pressure, vigorous sneezing,11 through the same mechanism of the cough.…”

Section: Discussionmentioning

confidence: 99%

Recurrent bilateral periorbital and circumoral bruising due to vomiting

Al-Sardar

2014

BMJ Case Reports

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Periorbital ecchymosis is due to extravasations of blood into the periorbital skin and the subcutaneous tissues around the eyes. ‘raccoon eyes’ or ‘panda sign’ is a distinctive type of periorbital ecchymosis where the bruising is characterised by tarsal sparing. This sparing is due to an anatomical structure called the orbital septum, which limits the spread of the discolouration beyond the tarsal plate. Hence ‘raccoon eyes’ description should be limited to orbital ecchymosis due to basal skull fractures only. While the bilateral bruising due to direct trauma to the eyes, or non-traumatic medical conditions, can spread beyond the tarsal plate as in our case. The differential diagnosis varies from trivial benign conditions to serious life-threatening illnesses. We describe a case of recurrent bilateral periorbital ecchymosis and facial bruising due to vomiting.

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Section: Discussionmentioning

confidence: 99%

Recurrent bilateral periorbital and circumoral bruising due to vomiting

Al-Sardar

2014

BMJ Case Reports

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“…Multilayered ODH in IIH are rare and were not found in patients enrolled in the IIH Treatment Trial. Subretinal hemorrhages [ 3 ] and preretinal hemorrhages [ 4 ] have previously been identified in IIH patients in isolation, and we identified one case with a combination of preretinal and intraretinal hemorrhages in one eye [ 5 ]. The eye that had multilayered hemorrhages had only mild vision loss at presentation with a mean deviation of −4.00 dB and an enlarged blind spot on Humphrey visual field testing and had a good visual outcome.…”

Section: Discussionmentioning

confidence: 99%

Three-Layered Optic Disc Hemorrhages in Idiopathic Intracranial Hypertension

Micieli

2021

Case Rep Ophthalmol

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Papilledema related to idiopathic intracranial hypertension (IIH) may present with optic disc hemorrhaging. The significance and characteristics of these hemorrhages still remains to be clarified. Here, we present 2 unique cases with severe unilateral optic disc hemorrhaging in all 3 retinal layers (preretinal, intraretinal, and subretinal) and a good visual outcome. A 42- and a 44-year-old woman presented with signs and symptoms of raised intracranial pressure. Visual acuity was normal and Humphrey visual field testing showed only mild vision loss with enlarged blind spots. Dilated fundus examination revealed moderate papilledema in both eyes with severe optic disc hemorrhaging in the left eye in the first patient and the right eye in the second patient. The optic disc hemorrhaging occurred in all 3 retinal layers (preretinal, intraretinal, and subretinal), and the fellow eyes had only minimal hemorrhage. All patients had normal magnetic resonance imaging/magnetic resonance venography, and lumbar punctures revealed elevated opening pressures and normal cerebrospinal fluid contents. The papilledema resolved after 4 months in both cases with medical therapy. Optic disc hemorrhaging may be severe in patients with IIH, but this does not necessarily confer a poor visual outcome. The differential diagnosis of hemorrhages in all 3 retinal layers may be expanded to include IIH.

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“…Idiopathic intracranial hypertension, (1) migraine headache, (2,3) cavernous sinus thrombosis, (4) superior sagittal sinus thrombosis, (5) dural sinus thrombosis, (6) metastatic neuroblastoma involving base of the skull (7,8) etc. are been reported associated with intracranial pathologies.…”

Section: Discussionmentioning

confidence: 99%

A misleading Periorbital Hematoma..Case Report

Debbarma¹

2020

IJFMTS

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Periorbital ecchymosis or hematoma is due to extravasations or collections of blood into the periorbital skin and the subcutaneous tissues around the eyes. 'Spectacle hematoma' 'raccoon eyes' or 'panda sign' is a distinctive type of periorbital hematoma. A six year old girl brought in the casualty accompanied by her mother with complain of severe cough, left periorbital blackening, running nose, nose block and mild fever for 7 days.

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Subretinal haemorrhage in idiopathic intracranial hypertension

Cited by 9 publications

References 4 publications

Recurrent bilateral periorbital and circumoral bruising due to vomiting

Recurrent bilateral periorbital and circumoral bruising due to vomiting

Three-Layered Optic Disc Hemorrhages in Idiopathic Intracranial Hypertension

A misleading Periorbital Hematoma..Case Report

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