Neovascular glaucoma as a first clinical manifestation of multiple sclerosis.
OBJECTIVE
To report a case with neovascular glaucoma caused by severe occlusive retinal vasculitis, as a first clinical manifestation of multiple sclerosis (MS).


METHODS
Examination on an otherwise healthy 45-year-old man presenting with blurred vision in his right eye revealed bilateral iris neovascularization, right eye neovascular glaucoma, and bilateral retinal neovascularization caused by vasculitis. Thorough systemic investigation indicated by an ophthalmologist showed nothing else other than typical to MS imaging and spinal tap findings. The patient received bilateral treatment with panretinal photocoagulation and intravitreal bevacizumab (Avastin, Genentech, Inc., South San Francisco, CA) injection in the right eye.


RESULTS
Ten months later, the patient was found with paraclinical neurologic findings completing the diagnostic criteria of definite laboratory supported MS. After the 3 years that followed, the ocular disease was eliminated, and the underlying disease remains clinically silent.


CONCLUSIONS
As illustrated by our case, MS should be considered as an underlying disorder in patients with neovascular glaucoma caused by occlusive retinal vasculitis.
From the *Ophthalmology Department, †Neurology Department, and ‡3rd Internal Medicine Department, University of Thessaly, Larissa, Greece.
Maria G
MG
Kotoula
Andreas
A
Katsanos
Efthimios
E
Dardiotis
Georgios M
GM
Hadjigeorgiou
Georgia
G
Papadamou
Dimitrios Z
DZ
Chatzoulis
Evangelia
E
Tsironi