Etiology and Treatment of Choroidal Neovascularization in Pediatric Patients. Issue 5 (September 2016)

• Record Type: Journal Article
• Authors: Barth, Teresa; Zeman, Florian; Helbig, Horst; Oberacher-Velten, Isabel
• Is Part Of: European journal of ophthalmology. Volume 26:Issue 5(2016)
• Page Start: 388
• Page End: 393
• Publication Date: 2016-09
• Subjects: Anti–vascular endothelial growth factor -- Choroidal neovascularization -- Intravitreal injections -- Pediatric retinal disease -- Visual impairment; Ophthalmology -- Periodicals; Eye -- Diseases -- Periodicals; 617.7005
• DOI: 10.5301/ejo.5000820
• Languages: English
• ISSNs: 1120-6721

Abstract

Purpose: To assess the etiology, clinical features, and outcome of choroidal neovascularization (CNV) in children. Methods: We retrospectively assessed 10 eyes of 8 patients younger than 18 years diagnosed with CNV. The main clinical parameters included predisposing ocular pathologies, best-corrected visual acuity before and after treatment, characteristics of CNV, and treatment modalities. Results: Two boys and 6 girls with CNV and a mean age of 13.9 years (SD 1.9, range 11-16 years) were included. Two patients developed bilateral CNV within the follow-up time. The development of CNV was secondary to the following pathologies: choroidal osteoma (n = 3), pathologic myopia (n = 1), punctate inner choroidopathy (n = 1), hereditary macular dystrophy (n = 2), and angioid streaks (n = 1). Idiopathic CNV was diagnosed in 2 children without any obvious associated ocular pathology. In 9 eyes, CNV was treated by intravitreal anti–vascular endothelial growth factor (VEGF) administration (n = 6), photodynamic therapy (n = 1), or combination therapy (n = 3). One eye remained untreated because of advanced disease. Conclusions: Pediatric CNV is a rare but sight-threatening retinal disease. So far, no standard treatment has been validated. Since the establishment of intravitreal anti-VEGF therapy, laser coagulation and photodynamic therapy have lost their significance as therapy for CNV.