alexa Unilateral papilledema and choroidal folds: an uncommon
ISSN: 2161-1076

Surgery: Current Research
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Case Report

Unilateral papilledema and choroidal folds: an uncommon presentation of idiopathic intracranial hypertension

Gordon SK Yau1, Jacky WY Lee1*, Theo TK Chan2 and Can YF Yuen1

1Department of Ophthalmology, The University of Hong Kong, Hong Kong Special Administrative Region, China

2Department of Anatomy, Faculty of Medicine, University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, Hong Kong

*Corresponding Author:
Jacky W.Y. Lee
Department of Ophthalmology, Caritas Medical Centre
111 Wing Hong Streets, Kowloon
Hong Kong Special Administrative Region, China
Tel: +852 3408-7911
Fax: +852 2307-0582
E-mail: [email protected]

Received date: March 10, 2014; Accepted date: April 25, 2014; Published date: May 02, 2014

Citation: Gordon SKY, Jacky WY Lee, Theo TKC, Can YFY (2014) Unilateral Papilledema and Choroidal Folds: An Uncommon Presentation of Idiopathic Intracranial Hypertension. Surgery Curr Res 4: 193. doi:10.4172/2161-1076.1000193

Copyright: © 2014 Gordon SK Yau, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



The typical presenting ocular signs of idiopathic intracranial hypertension (IIH) include bilateral papilledema, enlarged blind spots, and abducens nerve palsy. Unilateral papilledema with choroid folds is an atypical presenting sign of IIH. The authors report the case of a 55-year-old Chinese gentleman, of medium-built, presenting with right eye transient visual obscuration associated with tinnitus for 2 weeks. Physical examination revealed ipsilateral choroidal folds and disc swelling. Computerized tomography of the brain and orbit with contrast revealed no intracranial space occupying lesions. Lumber puncture revealed an elevated opening cerebrospinal fluid pressure (30 cmH₂O) with normal biochemistry. Subsequent contrast Magnetic Resonance Imaging of the brain and orbit with venogram revealed features of empty sella, compatible with the diagnosis of IIH. He was subsequently treated with oral acetazolamide for 6 months and the symptoms resolved. Unilateral papilloedema with choroidal folds is an uncommon presentation of IIH, a lumbar puncture with opening pressure measurement and proper neuro-imaging should be considered when there is suspicion of IIH


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