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Letter to the Editor
Cerebral venous thrombosis presenting as acute visual loss
  1. YU-CHIEH KO
  1. Department of Ophthalmology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
  2. The Neurological Institute, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
  3. Department of Ophthalmology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
  1. WEI-TA CHEN
  1. Department of Ophthalmology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
  2. The Neurological Institute, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
  3. Department of Ophthalmology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
  1. PO-KANG LIN,
  2. WEN-MING HSU,
  3. JORN-HON LIU
  1. Department of Ophthalmology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
  2. The Neurological Institute, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
  3. Department of Ophthalmology, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan
  1. Po-Kang Lin, MD, Department of Ophthalmology, Taipei Veterans General Hospital, 201, Sec 2, Shih-Pai Road, Taipei, Taiwan 112 pklin{at}vghtpe.gov.tw

https://doi.org/10.1136/bjo.85.9.1139b

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    Editor,—The common features associated with cerebral venous thrombosis (CVT) are headache, papilloedema, motor or sensory deficits, seizures, and conscious disturbance.1Ophthalmological manifestations including diplopia, subnormal visual acuity, or visual field defect are primarily the consequence of increased intracranial pressure (IICP).2 Visual disorientation, psychic gaze paralysis, and inferior altitudinal hemianopsia may develop if cerebral infarction is complicated in the parieto-occipital (P-O) region.3 We describe an unusual oriental case of CVT presenting uncommon transient visual loss to stress the diversity of the manifestations of CVT.

    CASE REPORT

    A 54 year old woman suffered from sudden onset of severe headache and progressive visual loss in both eyes within 1 day. Her past history was unremarkable but her family history was significant for thrombophilia, pulmonary embolism (her father), and deep vein thrombosis (her son). She had just undergone hormone replacement therapy with oral conjugated oestrogen and medroxyprogesterone for 1 month.

    On admission, she was conscious. Blood pressure was 156/84 mm Hg. Physical and neurological examinations were normal. Ophthalmic examinations disclosed corrected visual acuity of 1/60 in the right eye and counting fingers in the left eye. Both eyes exhibited …

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