SERPIGINOUS CHOROIDITIS – A RARE CAUSE OF NEOVASCULAR GLAUCOMA

Neovascular glaucoma (NVG) is considered to be one of the rarest and most complex types of ophthalmologic diseases known up to the present moment, and is mainly caused by the obstruction of the iridocorneal angle through a neovascular membrane. We present the case of the patient MC, aged 46, who came to the Ophthalmologic emergency room of the University Emergency Hospital of Bucharest (SUUB), complaining of red, painful left eye (OS) as well as a severe decrease of the visual acuity (VA) in the left eye (OS).In the patient’s medical record it is noted a surgical procedure for cataract which he underwent in another clinic 2 months prior to the current presentation.Systemically hypotensor treatment was instituted, topically an intravitrous Bevacizumab injection followed by scleral flap trabeculectomy in the left eye (OS). As a result, the evolution was favorable including a decrease in the intraocular pressure. The patient is discharged, with immunosuppressive therapy for serpiginous choroiditis according to the rheumatologic findings (Cyclosporine).Serpiginous choroiditis is an inflammatory lesion of unknown etiology part of the White Dot Syndromes (WDS), probably the most severe form of them. It is a very rare condition, and in the cases of patients with serpiginous choroiditis the frequency of the choroidal neovascularisation is reduced and the neovascular glaucoma is exceptional. The surgical treatment of the neovascular glaucoma has poorer long-term prognosis compared to other forms of glaucoma.The peculiarity of the case comes both from the rare cause of the neovascular glaucoma, specifically the serpiginous choroiditis, also a rare autoimmune disorder, and the need for clinical cooperation between the ophthalmologist and immunologist or a rheumatologist in order to establish the adequate treatment and follow-up.