Some theorize that papillophlebitis develops from inflammation of the retinal or papillary vessels. Histopathological sections in papillophlebitis have demonstrated extensive phlebitis and obliteration of lumens of arterioles and mononuclear inflammatory infiltration of the central retinal veins. As with true CRVO, papillophlebitis may develop extensive areas of retinal non-perfusion with subsequent neovascularization of the posterior or anterior segment and neovascular glaucoma. Management Typically, papillophlebitis is a non-ischemic occlusion that can be expected to resolve in three to six months. Potential neovascularization of the disc, retina, iris, and angle must be carefully monitored, and referred to a retinal specialist if discovered.
Prognosis is determined by the amount of initial capillary non-perfusion.
If papillophlebitis is initially non-ischemic, then prognosis is good. Fortunately, the vast majority of cases will be non-ischemic. Due to the unknown etiology of papillophlebitis, the optimal treatment has yet to be determined. It is unclear whether or not anticoagulant therapy improves final visual outcome. Though it is theorized that papillophlebitis is an inflammatory condition, systemic steroids have not been demonstrated to be effective.