Rakusiewicz-Krasnodębska Klaudia, Jędrzejczak-Młodziejewska Joanna, Kanigowska Krystyna, Hautz Wojciech
Department of the Pediatric Ophthalmology, Children's Memorial Health Institute, 04-730 Warsaw, Poland.
Biomedicines. 2025 Jan 9;13(1):148. doi: 10.3390/biomedicines13010148.
Neovascular glaucoma is a rare and serious condition typically associated with advanced ocular or systemic vascular diseases such as central retinal vein occlusion or diabetic retinopathy. This report describes a unique case of neovascular glaucoma presenting for the first time as an initial symptom of bilateral occlusive retinal vasculitis (ORV) in a generally healthy 4-year-old girl. The patient presented with symptoms of pain and redness in the left eye, accompanied by high intraocular pressure. These symptoms were particularly distressing and uncharacteristic for such a young child. Clinical examination revealed significant findings, including elevated intraocular pressure, corneal edema, and iris neovascularization in the left eye. Additional imaging studies, including fluorescein angiography, demonstrated extensive retinal ischemia with peripheral capillary nonperfusion, confirming the diagnosis of occlusive vasculitis. The management of this case was challenging due to the progressive and aggressive nature of the disease in a 4-year-old patient. This article aims to present the diagnostic and therapeutic strategies for the management of this condition. This report highlights a rare case of neovascular glaucoma as the first manifestation of bilateral ORV in a young child. The unusual presentation emphasizes the need for a high index of suspicion and comprehensive evaluation in cases of pediatric neovascular glaucoma. Early diagnosis and prompt, multimodal treatment are crucial in preventing irreversible vision loss in such cases.
新生血管性青光眼是一种罕见且严重的病症，通常与晚期眼部或全身性血管疾病相关，如视网膜中央静脉阻塞或糖尿病性视网膜病变。本报告描述了一例独特的新生血管性青光眼病例，首次表现为一名总体健康的4岁女孩双侧闭塞性视网膜血管炎（ORV）的初始症状。该患者出现左眼疼痛和发红症状，伴有高眼压。这些症状对于如此年幼的儿童来说尤为痛苦且不典型。临床检查发现了显著体征，包括左眼眼压升高、角膜水肿和虹膜新生血管形成。包括荧光素血管造影在内的其他影像学检查显示广泛的视网膜缺血伴周边毛细血管无灌注，确诊为闭塞性血管炎。由于该疾病在一名4岁患者中具有进行性和侵袭性，该病例的管理具有挑战性。本文旨在介绍该病症管理的诊断和治疗策略。本报告强调了一例罕见的新生血管性青光眼病例，其为一名幼儿双侧ORV的首发表现。这种不寻常的表现强调了在小儿新生血管性青光眼病例中需要高度怀疑并进行全面评估。早期诊断以及及时、多模式治疗对于预防此类病例中不可逆转的视力丧失至关重要。
