FP1229 : Atypical presentation of peri-papillary choroidal neovascularization with associated disc swelling

Dr.Satish Chadha, C14378

Case report of a patient presented with unilateral loss of vision in the left eye (0.2). Examination, OCT, FFA and lab tests revealed juxta-papillary choroidal neovascularization with macular degeneration bilaterally and sub-retinal haemorrhages .

Patient received sequential intravitreal injections of Ranibizumab ( Lucentis) with regular monitoring. Visual acuity and clinical symptoms remained stable.10 month’s later visual acuity dropped to 0.7 with and disc swelling. CT scan, MRI, lumbar puncture, and blood tests were normal. No response with systemic steroids after neuro-ophthalmology consultation. VA dropped (0.8) after initial improvement.

There was regression of the disc swelling and resolution of retinal haemorrhages following intravitreal Ranibizumab injections to an extent.

Ranibizumab administration was not completely effective in treating macular degeneration with juxta-papillary choroidal neo-vascularisation.

The association with disc swelling is most unusual.