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Papilledema

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Swelling of the OPTIC DISK, usually in association with increased intracranial pressure, characterized by hyperemia, blurring of the disk margins, microhemorrhages, blind spot enlargement, and engorgement of retinal veins. Chronic papilledema may cause OPTIC ATROPHY and visual loss. (Miller et al., Clinical Neuro-Ophthalmology, 4th ed, p175)

Also Known As:

Decreased Intraocular Pressure-Associated Papilledema; Increased Intracranial Pressure-Associated Papilledema; Papilledema Associated with Decreased Intraocular Pressure; Papilledema Associated with Increased Intracranial Pressure; Retinal Edema; Choked Disks; Disk, Choked; Disks, Choked; Edema, Optic Disk; Edema, Optic Papilla; Edema, Retinal; Edemas, Optic Disk; Edemas, Optic Papilla; Edemas, Retinal; Increased Intracranial Pressure Associated Papilledema; Optic Disk Edemas; Optic Papilla Edemas; Optic Papillitis; Papilledemas; Retinal Edemas; Choked Disk; Optic Disk Edema; Optic Papilla Edema; Papillitis, Optic

Networked: 633 relevant articles (47 outcomes, 29 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Headache (Headaches)
2.	Hemorrhage
3.	Pseudotumor Cerebri (Idiopathic Intracranial Hypertension)
4.	Inflammation
5.	Atrophy

Experts

1.	Wall, Michael: 6 articles (10/2015 - 03/2002)
2.	Kupersmith, Mark J: 6 articles (10/2015 - 08/2011)
3.	Shields, Carol L: 6 articles (01/2012 - 09/2004)
4.	Bringmann, Andreas: 5 articles (01/2016 - 07/2006)
5.	Wiedemann, Peter: 5 articles (01/2016 - 07/2006)
6.	Reichenbach, Andreas: 5 articles (01/2016 - 07/2006)
7.	Dispenzieri, Angela: 5 articles (06/2012 - 06/2004)
8.	Ophir, Avinoam: 5 articles (05/2011 - 05/2009)
9.	Pannicke, Thomas: 4 articles (01/2016 - 07/2006)
10.	Kardon, Randy H: 4 articles (07/2012 - 06/2010)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Papilledema:

1.	Retinaldehyde (Retinal)IBA 05/01/2006 - "OCT was very useful for evaluating the severity of the retinal edema and the temporal changes in the retinal profile." 01/01/2016 - "Water accumulation in retinal glial (Müller) and neuronal cells resulting in cellular swelling contributes to the development of retinal edema and neurodegeneration. " 09/01/2015 - "The patterns of retinal and choroidal folds are the products of a complex interplay between the degree of papilledema and anterior deformation of the load-bearing structures (sclera and possibly the lamina cribrosa), both modulated by structural geometry and material properties of the optic nerve head. " 09/01/2015 - "We identified three types of folds in IIH patients with papilledema: peripapillary wrinkles (PPW), retinal folds (RF), and choroidal folds (CF). " 09/01/2015 - "Retinal and Choroidal Folds in Papilledema."
2.	Acetazolamide (Diamox)FDA LinkGeneric 03/01/2002 - "Two patients had persistent but improved papilledema and are under continued treatment with acetazolamide and CPAP. " 09/01/2014 - "Her papilledema improved following administration of acetazolamide. " 10/01/2015 - "Despite the association of POEMS with papilledema, treatment for this finding typically includes acetazolamide and therapeutic large volume lumbar punctures. " 04/23/2014 - "Mean improvements in papilledema grade (acetazolamide: -1.31, from 2.76 to 1.45; placebo: -0.61, from 2.76 to 2.15; treatment effect, -0.70; 95% CI, -0.99 to -0.41; P < .001) and vision-related quality of life as measured by the National Eye Institute VFQ-25 (acetazolamide: 8.33, from 82.97 to 91.30; placebo: 1.98, from 82.97 to 84.95; treatment effect, 6.35; 95% CI, 2.22 to 10.47; P = .003) and its 10-item neuro-ophthalmic supplement (acetazolamide: 9.82, from 75.45 to 85.27; placebo: 1.59, from 75.45 to 77.04; treatment effect, 8.23; 95% CI, 3.89 to 12.56; P < .001) were also observed with acetazolamide. " 07/01/2010 - "Despite anticoagulation therapy and acetazolamide, she had severe, nonresolving papilledema. "
3.	bevacizumab FDA Link 02/01/2009 - "Within 2 weeks of bevacizumab injection, visual acuity improved from 20/40 to 20/25 and optical coherence tomography revealed complete resolution of CNV and retinal edema. " 09/01/2012 - "Bevacizumab appears to be an effective option for patients who have subretinal neovascular membranes due to papilledema. " 09/01/2012 - "Intravitreal bevacizumab for peripapillary subretinal neovascular membrane associated to papilledema: a case report." 07/01/2010 - "Bevacizumab effectively decreases vascular permeability and retinal edema in the short term." 07/01/2015 - "This paper aimed to explore clinically curative effect of intravitreal injection of bevacizumab in the treatment of macula lutea and retinal edema of ocular fundus disease. "
4.	Fluorescein (Funduscein)FDA LinkGeneric 08/01/1968 - "A fluorescein angiographic study of resolving papilledema." 12/01/2015 - "Parafoveal area thickness significantly decreased in both groups from month 1, with greater decrease in the TA group at months 2 and 3. Leakage area on fluorescein angiography was significantly smaller in the TA group at months 1 to 3. Intraocular pressure increased in the TA group at months 1 and 2. Intravitreal TA injection showed earlier reduction of leakage and retinal edema compared to systemic anti-inflammatory treatment alone." 11/01/2011 - "Analyzing the visual acuity, no statistical correlation was found between gender, disease duration or presence of retinal edema in fluorescein angiography or optical coherence tomography. " 01/01/2009 - "After 4 months return of normal visual acuity was noted, as well as lack of retinal edema in fluorescein angiography." 01/01/2004 - "We suggest that low serum ALB enhances the permeability of the vessels in or around the optic disk and induces subclinical optic disk edema, which is characterized by late fluorescein staining and high blood flow velocities in the CRA and CRV."
5.	ranibizumab (Lucentis)FDA Link 12/01/2012 - "After 1 injection of intravitreal ranibizumab, retinal edema totally regressed and BCVA improved to 6/10. " 07/01/2008 - "Although neurosensory retinal edema and SRF showed an early reduction to nadir after the initiation of ranibizumab therapy, the effect on the retina was attenuated over time, suggesting possible tachyphylaxis. " 01/01/2012 - "Persistent vitreomacular traction along with the decrease in retinal edema after intravitreal ranibizumab could have contributed to the formation of lamellar macular hole. " 07/01/2011 - "The preliminary results of this prospective study indicate that combination treatment with intravitreal ranibizumab injection and reduced fluence photodynamic therapy for choroidal neovascularization associated with angioid streaks seems to be effective in reducing or eliminating retinal edema, regression of neovascularization, and improving or stabilizing visual acuity without any complications. " 05/01/2012 - "The resolution rate of retinal edema was not significantly different between the bevacizumab and ranibizumab group (p = 0.960). "
6.	1-phenyl-3,3-dimethyltriazene (PDT)IBA 04/01/2008 - "IVTA-PDT for eyes with RAP, in which PDT had been performed several times, may be effective for improvement or elimination of retinal edema, achieving rapid regression of neovascularization, and stabilizing visual acuity." 05/01/2011 - "Secondary classic CNV tends to develop after PDT in PCV eyes in younger patients with retinal edema." 04/01/2008 - "Complete resolution of angiographic leakage and improvement of retinal edema and RPED were observed at the examination 3 months after IVTA-PDT. " 07/01/2009 - "Sequenced combined treatment with single-session PDT and IVB injections may be useful in treating RAP, reducing or eliminating retinal edema, and improving or stabilizing visual acuity. " 04/01/2008 - "During IVTA-PDT, leakage from neovascularization was observed on angiography, and retinal edema and retinal pigment epithelial detachment (RPED) were observed on optical coherence tomography (OCT), even though PDT had been performed several times in all 5 eyes receiving IVTA-PDT. "
7.	Vitamin E FDA LinkGeneric 11/01/2002 - "The protective effects of melatonin, vitamin E and octreotide on retinal edema during ischemia-reperfusion in the guinea pig retina." 10/01/2004 - "Protective effects of vitamin E forms (alpha-tocopherol, gamma-tocopherol and d-alpha-tocopherol polyethylene glycol 1000 succinate) on retinal edema during ischemia-reperfusion injury in the guinea pig retina."
8.	MelatoninIBA 09/01/2004 - "Protective effects of intraperitoneal vitamin C, aprotinin and melatonin administration on retinal edema during experimental uveitis in the guinea pig." 11/01/2002 - "The protective effects of melatonin, vitamin E and octreotide on retinal edema during ischemia-reperfusion in the guinea pig retina."
9.	Vascular Endothelial Growth Factor A (Vascular Endothelial Growth Factor)IBA 04/01/2014 - "Our results establish VEGF as a major cytokine regulating RPE barrier properties in vivo and indicate that the RPE is a principal factor in the pathogenesis of retinal edema." 12/01/2008 - "Increased production of VEGF results in disruption of the blood retinal barrier leading to retinal edema. " 06/01/2006 - "Thus, HGF may represent another clinically significant contributor to retinal edema distinct from the actions of VEGF." 03/01/1999 - "VEGF elictes angiogenesis and increased vascular permeability (retinal edema). " 07/01/2015 - "The control group was age-matched to the study group and consisted of subjects who demonstrated complete resolution of retinal edema on OCT after 3 or fewer monthly anti-VEGF injections. "
10.	Minocycline (Cyclops)FDA LinkGeneric 08/01/2013 - "Intraperitoneal administration of minocycline significantly ameliorated retinal edema in the early stage of BRVO. " 01/01/1988 - "[Papilledema caused by minocycline: apropos of a case]." 01/01/2009 - "Minocycline-associated pseudotumor cerebri with severe papilledema." 07/01/1998 - "One patient was asymptomatic, and pseudotumor cerebri syndrome was diagnosed by finding papilledema on routine examination 1 year after minocycline was started. " 01/01/1992 - "A case is reported of a 16-year-old girl who developed benign intracranial hypertension, with severe bilateral papilledema after minocycline therapy. "

Therapies and Procedures

1.	Aftercare (After-Treatment) 01/01/2014 - "There may be delayed onset of an unknown pathophysiology in the visual system after treatment for the underlying cause of papilledema, implying an uncertain visual prognosis for patients with this condition." 01/01/2015 - "The follow-up visit two days after treatment revealed significant central retinal edema and subretinal fluid. " 04/01/2014 - "To report feasibility and reliability of a semi-automated image analysis method for retinal vessel diameter measurements in subjects with papilledema before and after treatment. " 11/01/2011 - "One or 2 months after treatment, spectral-domain optical coherence tomography demonstrated almost entirely obliterated RAMs and decreased perianeurysmal retinal edema. " 01/01/2011 - "Eleven days after treatment, the visual acuity was 9/10 with no retinal edema. "
2.	Stents 09/01/2011 - "In all 52 patients, stent placement immediately eliminated the TSS pressure gradient, rapidly improved IIH symptoms, and abolished papilledema. " 03/01/2012 - "Stent placement is durable and successfully eliminates papilledema in appropriately selected patients. " 11/01/2010 - "Even though this pathology remains misunderstood, we observed a significant decrease in papilledema in IIH after lateral sinus stent placement, suggesting that high intracranial venous pressure could play a role in this pathology." 09/01/2001 - "To report two cases of cerebral venous sinus thrombosis with papilledema and visual loss that improved after endovascular stent placement. " 09/01/2001 - "Improvement in papilledema and visual loss after endovascular stent placement in dural sinus thrombosis."
3.	Decompression 06/01/1998 - "Although optic nerve sheath decompression is a relatively safe and effective treatment for visual loss due to papilledema in adults, significant complications, including further visual loss, may occur. " 08/15/1991 - "We believe that patients with acute papilledema and visual loss should be offered optic nerve sheath decompression, and if symptoms recur, repeat optic nerve sheath decompression is a safe and effective treatment option." 08/15/1991 - "Of 32 eyes with chronic papilledema (18 patients), only ten had improved visual function after optic nerve sheath decompression. " 08/15/1991 - "Sixty-nine eyes (85 patients) with acute papilledema uniformly had improved visual function after optic nerve sheath decompression. " 01/01/2011 - "However, autoregulatory changes may be responsible for rapid visual loss following decompression for chronic papilledema. "
4.	Light Coagulation 07/01/2004 - "3 days after photocoagulation, retinal edema was relieved. " 06/01/2002 - "After photocoagulation of efferent vessels, CNV-related retinal edema was significantly reduced or resolved within 1 to 4 days. " 04/01/2002 - "The accumulated leukocytes may be involved in the augmented vascular permeability in the untreated retina, resulting in retinal edema after photocoagulation." 07/10/1979 - "[The direct working mechanism of photocoagulation in regard to the resorption of retinal edema (author's transl)]." 01/01/1999 - "In 16 patients laser photocoagulation applied for neovascularisation or retinal edema was necessary."
5.	Lasers (Laser) 04/01/2014 - "Scanning laser ophthalmoscopy (SLO) was performed in seven normal, five pseudopapilledema, and seven papilledema subjects. " 03/01/2014 - "(2) OCT images showed retinal edema, subretinal fluid and hyper-reflective lesions of CNVs in the laser sites and histopathology showed that fibrovascular tissues together with proliferating retinal pigment epithelium cells were seen in the laser sites. " 01/01/2013 - "Laser treatment in patients with DME significantly reduced central retinal edema in most segments." 06/01/2011 - "Indirect ophthalmoscopic reexamination confirmed secured blockage by laser spots and favorable absorption of the retinal edema and newborn capillaries. " 09/01/2007 - "Laser scanning tomography measurements are useful for evaluating the degree of papilledema in patients with IIH and correspond well with clinical data and measurements of CSF opening pressure. "