to rePort a rare caseof antiPhosPholiPid syndrome Presenting as PaPilledema and sixth nerve Palsy in right eye dueto suPerior sagittal sinusthrombosis, and regressionof PaPilledema following anticoagulation and acetazolamidetheraPy. ·METHODS: A 44-year-old Chinese gentleman Presented with headache, diPloPia and mild blurringof vision. Clinical examination revealedthe Presenceof sixth nerve Palsy in right eye and PaPilledema.there was enlargementof blind sPot inthe visual fields and red green deficiency in both eyes. ComPutedtomograPhy and magnetic resonance imaging showed suPerior sagittal sinusthrombosis. Hematological investigation confirmedthe Presenceof antiPhosPholiPid syndrome asthe underlying cause. ·RESULTS:the condition wastreated successfully inthree months withthe adjunctive useof anticoagulation and acetazolamide. Reversalof PaPilledema changes intheoPtic discto normal indicatesthe anatomical recovery, while reductionof enlargementof blind sPotto normal size, recoveryof red green deficienyto normal colour vision in both eyes and visual imProvement after regressionof PaPilledema in right eye indicate functional recovery inthis Patient. ·CONCLUSION: AntiPhosPholiPid syndrome should be consi- dered inthe differential diagnosisof PaPilledema, andoral acetazolamide is an imPortant adjuncttheraPyto anti- coagulation in casesof refractory PaPilledemato ProtecttheoPtic nerve from Potential damage which results in blindness.