Pediatric choroidal neovascularization: Etiology and treatment outcomes with anti-vascular endothelial growth factors

Eur J Ophthalmol. 2022 Jul;32(4):2355-2367. doi: 10.1177/11206721211048799. Epub 2021 Oct 7.

Abstract

Purpose: To describe the etiology and treatment outcomes of choroidal neovascularization (CNV) in a pediatric population with intravitreal anti-vascular endothelial growth factors (VEGF).

Methods: Retrospective single center interventional case series. A total of 26 eyes of 23 consecutive pediatric patients with CNV of various etiologies were treated with intravitreal injection of anti-VEGF agents.

Results: There were 15 males (65.2%) and eight females (34.8%), diagnosed with CNV during the study period. The mean age at presentation with CNV was 11.7 ± 3.3 years, (range 4-16 years) and the mean follow was 28.1 ± 18 months, (range 8-72 months). Inflammatory CNV was the most common etiology. The mean best corrected visual acuity (BCVA) and mean central macular thickness (CMT) at presentation, were logMAR 0.8 ± 0.3 and 367.6 ± 134.8 µm respectively. At the final visit, CNV in all eyes remained regressed with significant improvement in mean BCVA to logMAR 0.4 ± 0.4 (p < 0.0001) and mean CMT to 242.5 ± 82.4 µm (p < 0.0001). A mean of two intravitreal injections per eye was required for CNV regression.

Conclusion: Intravitreal anti-VEGF therapy for pediatric CNV is an effective treatment in majority of affected eyes.

Keywords: CNV; Choroidal neovascularization; anti-VEGF; anti-vascular endothelial growth factor; pediatric choroidal neovascularization.

MeSH terms

  • Adolescent
  • Angiogenesis Inhibitors* / therapeutic use
  • Bevacizumab / therapeutic use
  • Child
  • Child, Preschool
  • Choroidal Neovascularization* / diagnosis
  • Choroidal Neovascularization* / drug therapy
  • Choroidal Neovascularization* / etiology
  • Female
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Male
  • Retrospective Studies
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Bevacizumab