Papillophlebitis: Treatment of Vision Loss Due To Subretinal Fluid with Intravitreal Ranibizumab

Abstract

There are no specific treatment protocols for papillophlebitis, which is basically a central retinal vein occlusion (CRVO) occurring in young adults. The present report is that of a 14-year-old girl, who presented with blurred vision in her right eye. Although her visual acuity (VA) was initially 20/20, there were venous engorgements, blurry disc margins, and a substantial collection of subretinal fluid. She was diagnosed with papillophlebitis. When, 2 weeks later, her VA had decreased to 20/200, she was administered intravitreally injected ranibizumab. One week post-injection, her VA had returned to normal (20/20) and the subretinal fluid had diminished markedly. Intravitreal ranibizumab injection appears to be an effective treatment modality for this condition.

Keywords: Anti-VEGF; central retinal vein occlusion; macular oedema; papillophlebitis; ranibizumab.

FIGURE 1

(a–c) Fundus image, visual field test (with large blind spot), and submacular fluid by OCT at initial examination. (d–f) Image of vessels in early and middle phases, with leakage from the optic disc in the late phase of FFA in initial examination.

FIGURE 2

(a) Submacular fluid is present by OCT; VA was 20/20 by Snellen at initial examination. (b) Appearance at day 1 post-injection after injection; 2 weeks had elapsed between initial OCT and OCT shown in figure. (c–d) Submacular fluid had nearly completely disappeared by days 17 and 34 post-injection. VAs were 20/20 by Snellen at both visits. (e) Macular OCT 14 months post-injection; VA was 20/20.