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Jugular venous thrombosis secondary to idiopathic myelofibrosis: a rare cause of bilateral papilledema
Author(s) -
MATEO J,
JIMENEZ B,
ASCASO F,
LAVILLA L,
PEIRO C,
IBANEZ J
Publication year - 2012
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2012.t122.x
Subject(s) - medicine , papilledema , surgery , visual acuity , myelofibrosis , thrombosis , venous thrombosis , bone marrow , pathology
Purpose Idiopathic myelofibrosis is a chronic myeloproliferative disorder in which the bone marrow is progressively substituted by connective fibrous tissue.This is due to an increase of the fibroblast growth factor, produced by the megakaryocytes.Among its signs and symptoms, we can find extramedullary hematopoiesis with hepatosplenomegally, anemia, weight loss, bone pain, infections or coagulopathy.Bone marrow biopsy shows different degrees of fibrosis and nests of megakaryocytes.Patients receive mainly symptomatic treatment and,sometimes,chemotherapy. Methods We present the case of a 65‐year‐old woman diagnosed with idiopathic myelofibrosis.She complained of bilateral loss of vision after suffering a right internal jugular vein thrombosis.Her best corrected visual acuity was 20/40 in the right eye and 20/200 in the left eye.She developed a severe bilateral papilledema and macular edema, as well as retinal hemorrhages and peripapillary cotton wool spots. Results The patient was treated with systemic steroids and anti‐platelet therapy, showing great improvement, with a final visual acuity of 20/25 in the right eye and 20/30 in the left eye.The macular edema was recovered, along with the visual fields.The papilledema was significantly reduced after the treatment.She is now being treated with heparin and her visual acuity remains stable. Conclusion Jugular thrombosis is an uncommon cause of papilledema. Idiopathic myelofibrosis often causes platelet disorders which may lead either to thrombosis or easy bleeding.Ophthalmologists should be aware of internal jugular vein thrombosis as a possible cause of bilateral papilledema in patients suffering from diseases that can cause blood coagulation abnormalities.