Choroidal neovascularization in the pediatric age group

PURPOSE: The purpose of the study is to evaluate the clinical features, underlying etiology, and clinical outcomes of choroidal neovascularization (CNV) in the pediatric population.
METHODS: This is a retrospective, single-center, interventional case series. A total of 12 eyes of 12 consecutive pediatric patients with CNV with various etiologies were analyzed. The main clinical parameters included the underlying causes, best-corrected visual acuity before and after the treatment, characteristics of the CNV, and the treatment strategies.
RESULTS: There were four girls and eight boys with a median age of 12.3± 3 years (range: 7–17 years). Eight of 12 patients have completed the 6-month follow-up. The mean follow-up period was 32.8± 41 months (range: 6–132 months) in those 8 patients. Overall, five of them were treated. Four patients were treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) administration and the remaining patient with photodynamic therapy. Visual acuity improved from logMAR 0.54±0.2 (range: logMAR 0.8–0.2) to logMAR 0.26±0.18 (range: logMAR 0.5–0.1) at the last visit in the treated eyes. All anti-VEGF-treated patients required only a single injection.
CONCLUSION: CNV, a sight-threatening disease, is rarely seen in the pediatric age group. Families could be hesitant about the intravitreal treatment, but anti-VEGF injections seemed very helpful in our group of treated patients.

Keywords: Aflibercept, anti-VEGF, choroidal neovascularization, optical coherence tomography angiography, photodynamic therapy, ranibizumab