Dr.BIPASHA MUKHERJEE, M08124
A 13-year-old female presented with decrease in vision in both eyes with headache and vomiting for 15days. Her visual acuity was perception of light with inaccurate projection in right eye; counting fingers close to face in left. Pupils were non-reactive. Motility was restricted in all gazes. Fundus showed bilateral disc edema. Magnetic Resonance Angiography showed attenuated caliber of left ICA with occlusion of left MCA with collaterals, characteristic of Moyamoya disease. The patient underwent optic nerve sheath fenestration following which her vision improved to 3/60 in right and 6/24 in the left eye. Moyamoya disease is an occlusive disease of cerebral vasculature most commonly seen in the Japanese. Children usually present with ischemic events and can present with visual symptoms. Though rare, ophthalmologists should be aware of this disease and the treatment options for prompt management to salvage vision.
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