DR. JIZ MARY SANTHOSH

DR NEENA R, DR.A. GIRIDHAR

Abstract

11year old girl with 2 year history of gradually progressive vision loss in BE. Lumbar puncture had ruled out idiopathic intracranial hypertension(IIH) in 2015. BCVA in RE – CF1m and LE -6/24. She had RAPD in RE, defective colour vision in BE. Fundus examination showed BE pale elevated optic nerve head (ONH) with peripapillary bossy appearance increased in comparison to prior images.SD-OCT BE showed buried ONH drusen with peripapillary CNVM (PPCNVM)in the RE. OCTA confirmed the presence of scarred PPCNVM. LE visual field showed constricted fields. MRI brain with MRV was normal except for B/L thin optic nerves. Repeat LP confirmed a normal opening pressure. Supported by progressive disc swelling and defective vision, diagnosis of true disc edema with buried ONH drusen and PPCNVM of RE was entertained and trial of anti-VEGF injection administered. The progressive vision drop, previous suspicion of IIH, an obvious buried ONH drusen causing PPCNVM were challenges faced in diagnosis