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All Journal Ophthalmologica Indonesiana
STEVANUS PALILIEWU
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Health Professions Medicine & Pharmacology Public Health

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Bilateral Chronic Papilledema caused by Space Occupying Lesion: A Case Report: Poster Presentation - Case Report - Resident BEATRICE MARIA POLUAN; STEVANUS PALILIEWU; ROBBY TUMEWU
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/vj122y63

Abstract

Abstract Introduction : Papilledema is edema of optic disc due to raised intracranial pressure (ICP). Papilledema threatens both life and vision, therefore workup for the etiology of raised ICP is needed, including neuroimaging. Intracranial tumors cause increased ICP leads to papilledema. This case report caseof bilateral chronic papilledema as manifestation of space occupying lesion (SOL). Case Illustration : A 36 years old female presented with blurry black vision on the both eyes since 3 months ago. Complaints were felt suddenly with dominance on the left eye and accompanied with headache. Patient with 12 times history of motorcycle accidents without using helmet in the last 2 years. Funduscopy shows bilateral papilledema. MRI shows orbital within normal limit and solid lobulated mass extra-axial impression in the left posterior parietal region pressing on the left parietooccipital lobe with perifocal edema that obliterates the left lateral ventricle and results in a midline shift to the right. Neurosurgeon had planned for elective craniotomy tumor removal. Discussion : Increase in the total amount of intracranial tissue by SOL as underlying mechanism of raised ICP. SOL often causes intracranial hemorrhage, which frequently leads to papilledema. High ICP also produces a rise in CSF pressure surrounding the optic nerves leading to axoplasmic flow stasis, causing visual loss. High ICP due to SOL is typically treated surgically. Conclusion : This case explain that raised ICP caused by SOL leading to manifestation of papilledema.
DIRECT CAROTID CAVERNOSUS FISTULA: Poster Presentation - Case Report - Resident Monica Camilla Chandra; Stevanus Paliliewu; Robby Tumewu; Gilbert Tangkudung
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/n632gc31

Abstract

Abstract Introduction : Carotid cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system, most commonly due to head trauma from a basal skull fracture creating a tear in the internal carotid artery (ICA) within the cavernous sinus. Case Illustration : A 15 years old girl presented with orbital pain, swelling, swishing or buzzing sounds, headache, and vision loss. Five months ago, she had a history of traumatic injury and undergone craniotomy. From physical examination Orbital ultrasound presence with dilated superior ophthalmic vein, which appears as a hollow tubular structure with no internal echo. MRI scan show a mass suggestive carotid cavernosus fistula dextra. DSA result confirmed the diagnose as direct carotid cavernosus fistula dextra as communication between internal carotid artery and sinus cavernosus. The patient was treated with neuroprotective along medication followed by endovascular treatment from the neurointervention department. Discussion : The classic triad of CCF includes pulsatile exophthalmos, chemosis and orbital bruit. Ophthalmic manifestations of CCFs vary widely depending on underlying aetiology, type, size, location, blood flow rate and drainage route of the CCF. Patient initially undergo noninvasive imaging with orbital ultrasound and magnetic resonance imaging (MRI). Digital subtraction angiography is the gold standard in the diagnosis of CCF and must be performed before any potential intervention. Conclusion : This case describes a patient who was diagnose with direct carotid cavernous fistula of the right eye.
Co-Authors BEATRICE MARIA POLUAN Gilbert Tangkudung Monica Camilla Chandra Robby Tumewu