An Adolescent Case of Unilateral Papillophlebitis Treated with Intravitreal Bevacizumab

Abstract

Purpose: To report a case of papillophlebitis treated with an intravitreal bevacizumab injection in an adolescent patient.Case summary: A 15-year-old female with no medical history presented with a 3-day history of blurred vision and a floating sensation. The initial visual acuity (VA) was 0.0 logarithm of minimal angle of resolution (logMAR) in the left eye. A fundus examination revealed a blurry disc margin, peripapillary hemorrhage, and venous engorgement. Optical coherence tomography indicated subretinal fluid (SRF) accumulation. Both color vision and pupillary reactions were normal in bilateral eyes. Blood tests revealed no significant abnormalities. Brain magnetic resonance imaging (MRI) showed mild focal papillitis, but the patient did not report eye movement pain or discomfort. The diagnosis was papillophlebitis; however, high-dose steroid treatment was not initiated due to the absence of a significant decrease in VA. A single injection of intravitreal bevacizumab was administered to address the SRF. At the 9-month follow-up, VA remained at 0.0 logMAR, and the retina demonstrated anatomical stabilization after complete absorption of the SRF without recurrence.Conclusions: Papillophlebitis can manifest during adolescence. Treatment of a 15-year-old patient with intravitreal bevacizumab obviated the need for high-dose steroid therapy and produced favorable outcomes, including preservation of VA and anatomical stabilization of the retina.