Role of anti-TNF in Pediatric Inflammatory Choroidal Neovascularization: A Case Series

Ocul Immunol Inflamm. 2023 Jul;31(5):1006-1012. doi: 10.1080/09273948.2022.2081583. Epub 2022 Jun 8.

Abstract

Objective: To highlight the safety and efficacy of Tumor Necrosis Factor inhibitors (anti-TNF) in inflammatory choroidal neovascularization (CNV) in the pediatric population.

Design: Retrospective case series.

Participants: Three patients, < 16 years old with uveitic inflammatory CNV.

Methods: Patients received systemic steroids, methotrexate (MTX), intravitreal (IVT) injections of bevacizumab, and anti-TNF (infliximab or adalimumab) in case of refractory leakage.

Results: Five eyes of three pediatric patients (mean age 6 years old) presenting with CNV and put on anti-TNF were followed up for a minimum of 32 months. Four out of five eyes had improved vision, reduced fluid on clinical exam and macular spectral-domain optical coherence tomography (SD-OCT), and cessation of leakage on fundus fluorescein angiography (FFA) after introduction of anti-TNF agents. Two patients developed minor psoriasis treated topically.

Conclusion: Anti-TNF agents showed efficacy and safety in a sustainable leakage control of inflammatory pediatric CNV along with improvement in vision.

Keywords: Anti-TNF; anti-VEGF; case series; inflammatory CNV; leakage control; pediatric population; systemic steroids; vision improvement.

MeSH terms

  • Adolescent
  • Angiogenesis Inhibitors* / therapeutic use
  • Bevacizumab / therapeutic use
  • Child
  • Choroid / pathology
  • Choroidal Neovascularization* / diagnosis
  • Choroidal Neovascularization* / drug therapy
  • Choroidal Neovascularization* / epidemiology
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Tumor Necrosis Factor Inhibitors / therapeutic use
  • Vascular Endothelial Growth Factor A
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Tumor Necrosis Factor Inhibitors
  • Vascular Endothelial Growth Factor A
  • Bevacizumab