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REFERENCES
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FIG. 1. Fundus photograph (A) of the left eye demonstrates optic nerve edema with a cuff of subretinal fluid surrounding the
optic nerve. The macula demonstrates pigmentary alterations and evidence of subneurosensory fluid accumulation. A 6-mm
horizontal optical coherence tomography (OCT) scan (B) demonstrates subretinal fluid adjacent to the optic nerve as well as
in the macular region (asterisk).
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Papilledema Caused by
a Thoracic Schwannoma
Increased intracranial pressure rarely occurs with
spinal tumors at any level but is most common with upper
cervical tumors (1). There has been no report of
papilledema attributed to a thoracic schwannoma.
A 54-year-old man had headaches and papilledema
without other signs of nervous system dysfunction. Lumbar
puncture revealed an opening pressure of 440 mm water,
a protein level of 210 mg/dL, and a mild pleocytosis. Brain
CT and MRI showed no abnormalities. Accordingly, we
performed MRI of the spinal cord, which disclosed a T23
intraspinal tumor (Fig. 1). Surgical removal disclosed a
schwannoma. One month after the operation, there was no
headache, papilledema, or neurologic deficit. The lumbar
puncture was not repeated.
The five previously reported cases (26) of intraspinal schwannomas/neuromas and papilledema have
included tumors of the cauda equina, cervical spine, and
lumbar spine, but not thoracic spine.
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FIG. 1. Fluorescein angiography performed 14 days before intravitreal bevacizumab injection shows optic disc hypoperfusion
and macular pigmentary changes in the right eye and a classic subfoveal choroidal neovascular membrane in the left eye (arrow).
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FIG. 2. Fundus photography and fluorescein angiography of the left eye performed 8 days after intravitreal bevacizumab
injection show disc swelling with adjacent splinter hemorrhages and blockage of the peripapillary background fluorescence.
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