Intravitreal ranibizumab in the treatment of choroidal neovascularization secondary to morning glory syndrome in a child

Abstract

Congenital optic nerve abnormalities may rarely cause choroidal neovascularization (CNV). This case report summarizes the clinical and therapeutic outcomes of a 7-year-old boy with unilateral CNV secondary to morning glory syndrome associated with acute visual acuity loss. The patient was successfully treated with a single intravitreal ranibizumab injection. One month after the injection the visual acuity increased and optic coherence tomography (OCT) showed a decrease in the intraretinal fluid around the CNV. The patient was then called for monthly follow-up visits. No further treatment was needed for the next 12 months after the first treatment. There was no complication related to the injection.

Keywords: Choroidal neovascularization; Morning glory syndrome; Ranibizumab.

Figure 1

(a) Left photograph shows the infrared imaging of the morning glory disk in the right eye and right photograph shows the optical coherence tomography scan demonstrating a peripapillary choroidal neovascularization associated with intraretinal fluid (white star). (b) Left photograph shows the infrared imaging of the morning glory disk in the right eye and right photograph shows the optical coherence tomography scan demonstrating the decrease in the intraretinal fluid after the ranibizumab injection.

Figure 2

Right eye, fluorescein angiography reveals the staining of the peripapillary CNV and mild leakage in different phases before the treatment (white arrows).