Introduction: Craniofacial polyostotic fibrous dysplasia, as part of McCune-Albright syndrome, can have severe complications including vision loss. Also, patients with this syndrome are at greater risk of secondary intra-cranial pressure elevation due to medication side effects.
Background: : A 6-year-old girl with McCune-Albright syndrome and polyostotic craniofacial fibrous dysplasia and optic canal narrowing, developed signs of slowly progressive optic nerve compression on clinical examination including deteriorating visual acuity, positive relative afferent pupillary defect )RAPD) and bilateral optic disc swelling. Imaging using optical coherence tomography (OCT) revealed progressive retinal nerve fiber layer thickening. Prior to deterioration, the dose of triptorelin, a gonadotrophin-releasing hormone analogue, she was treated with for precocious puberty, was increased. Medication cessation was followed by improvement in clinical and imaging findings.
Conclusions: : McCune-Albright syndrome patients with craniofacial involvement and/or gonadotrophin-releasing hormone analogue treatment should be monitored regularly for clinical signs of optic neuropathy together with routine OCT imaging.
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