Neovascular Glaucoma, A Serious Condition

Neovascular glaucoma is serious sequela of an underlying ocular and/or advanced systemic disease. Retinal hypoxia and ischemia typically triggers the release of several known angiogenic factors, such as vascular endothelial growth factor (VEGF), which leads to retinal neovascularization, iris neovascularization (NVI) and anterior chamber angle neovascularization (NVA). Management of neovascular glaucoma consists of eliminating the underlying cause of the neovascularization and reducing elevated IOP. This is a case report of a patient, 1 year-old girl with symptoms of palpebral edema, conjuctival injection, irritation, from 4 days. Ocular examination revealed retinal edema with optic disc neovascularisation, elevated intraocular pressure, rubeosis iridis. B-scan showed thickness of the macular region and hiperecogenicity in the optic disc. MRI suggested a probable optic nerve glioma. Patient was treated with iv antibiotics, intraocular anti-VEGF injection, anti glaucomatous drugs, close follow-up. Differencial diagnosis was between neovascular glaucoma, optic nerve glioma, inflammatory neuritis.