Atlas of Ophthalmology

Bilateral Papilledema with Retinal Hemorrhages in Association with Orbital Metastases of Prostate Cancer (MRI, Colour Photography Posterior Pole, SD-OCT)

Optic Nerve -> Optic Disc (Disk, Optic Nerve Head) Swelling
Patient: 70 years of age, male, BCVA 0.5 at OD, 0.4 at OS, IOP 12/14 mmHg. Ocular Medical History: visual impairment of unknown history. General Medical History: prostata carcinoma with ossary metastasis in lateral orbital bones. Main Complaint: transient obscurations of vision. Purpose: to present optic nerve edema caused by ossary metastasis in orbital bone. Methods: MRI, Colour Photography Posterior Pole, SD-OCT. Findings: MRI: orbital metastases of lateral orbital bone (arrow). Colour Photography Posterior Pole: papilledema with retinal hemorrhages in OD and OS. SD-OCT: papilledema with thickened optic nerve head (1.5mm/1.6 mm) in OD and OS. Discussion: Matlach et al. (1) reported, that orbital metastases occur in 2-5 % of cancer patients. Breast, lung and prostate cancer cause orbital metastases, and in up to 25 % of patients orbital metastasis is the initial sign of an unknown primary tumor. Clinical symptoms are papilledema, proptosis, ocular motility disorder and visual impairment. Literature: (1) Matlach J, Nowak J, Göbel W. Papilledema of unknown cause. Ophthalmologe. 2013 Jun;110(6):543-5

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