We describe a 56-year-old female patient that presented with headache, unilateral optic disc edema and nasal visual field constriction. Laboratory and imaging investigation, clinical findings and response to treatment lead to the diagnosis of idiopathic intracranial hyperthension. We emphasize that unilateral papiledema can be an unusual clinical presentation of the syndrome and discuss its differential diagnosis and treatment.
Unilateral papiledema as an atypical presentating sign of idiopathic intracranial hyperthension
(A) Fundus photography of the right eye showing a circumscribed yellow-orange choroidal mass located along the inferotemporal vascular arcade. (B) Optical coherence tomography (OCT) demonstrating a dome-shaped choroidal mass with subretinal fluid, retinal pigment epithelium alterations, cystoid macular edema, and outer retinal damage.
PortesALF, RamosCDVF, NunesJS, ValdetaroR, MonteiroMLR. Unilateral papiledema as an atypical presentating sign of idiopathic intracranial hyperthension. Rev Bras Oftalmol. 2009;68(3):168-74.
Portes,André Luís Freire; Ramos,Carolina Do Val Ferreira; Nunes,Juliana dos Santos; Valdetaro,Renata; Monteiro,Mário Luiz Ribeiro. Unilateral papiledema as an atypical presentating sign of idiopathic intracranial hyperthension. Rev Bras Oftalmol., v. 68, n. 3, p. 168-174, Jun. 2009.
Portes,A.L.F., Ramos,C.D.V.F., Nunes,J.S., Valdetaro,R., & Monteiro,M.L.R. (2009). Unilateral papiledema as an atypical presentating sign of idiopathic intracranial hyperthension. Rev Bras Oftalmol.,68(3), 168-174.
Portes,André Luís Freire and Ramos,Carolina Do Val Ferreira and Nunes,Juliana dos Santos and Valdetaro,Renata and Monteiro,Mário Luiz Ribeiro. Unilateral papiledema as an atypical presentating sign of idiopathic intracranial hyperthension. Rev Bras Oftalmol. [online]. 2009, vol. 68, n. 3, [cited 2026-10-27], pp.168-174. Available from: <https://www.rbojournal.org/en/article/unilateral-papiledema-as-an-atypical-presentating-sign-of-idiopathic-intracranial-hyperthension/>. ISSN 0034-7280.