A fundus examination can reveal hypertensive retinopathy (in 40-100% of cases), exudative retinal detachments, white-centered retinal hemorrhages, papillophlebitis
, Elschnig spots, macular oedema, retinal pigment epithelial (RPE) defects, vascular occlusion, optic neuritis, optic atrophy, ischaemic optic neuropathy and cortical blindness.
Because papillophlebitis does not extend to the macula, visual acuity is mildly affected, but a wider blind spot is common on visual analysis.
Unlike CRVO, papillophlebitis spontaneously resolves, and its etiology also differs from that of CRVO.
In this case report we describe a bilateral, simultaneous papillophlebitis case thought to be related to hyperhomocysteinemia secondary to C677T polymorphism of the methylenetetrahyrofolate reductase (MTHFR) enzyme.
The patient's clinical findings were consistent with papillophlebitis, and visual evoked potential analysis revealed bilateral extended latencies.
Papillophlebitis has also been referred to in the literature as benign retinal vasculitis, optic disc vasculitis, peripapillary retinal vein occlusion, blind spot enlargement syndrome or venous papillopathy.
Papillophlebitis is not generally associated with any comorbidities, though hypertension has been detected in 23-42% of patients and diabetes mellitus in 3-9%.
9) reported the case of a 15-year-old girl with unilateral papillophlebitis who had hyperhomocysteinemia and homozygous mutations in MTHFR C677T and A1298C.
Although papillophlebitis resolves spontaneously, there have been attempts to speed recovery using different treatment protocols.
document a case with bilateral, simultaneous papillophlebitis
thought to be related to hyperhomocysteinemia secondary to methylenetetrahyrofolate reductase (MTHFR) (C677T) polymorphism.