Choroidal neovascular membrane in paediatric patients: clinical characteristics and outcomes

Padhi, Tapas Ranjan; Anderson, Bradley J.; Abbey, Ashkan M.; Yonekawa, Yoshihiro; Stem, Maxwell S.; Alam, Danish; Modi, Rohit Ramesh; Savla, Laxmi Prabhavathi; Trese, Michael T.; Capone, Antonio; Drenser, Kimberly A.; Besirli, Cagri G.

doi:10.1136/bjophthalmol-2017-310497

Cited by 17 publications

(15 citation statements)

References 18 publications

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“…In our series, identifiable ocular association could not be found in only 8/30 (26.7%) patients, whereas congenital/developing anomalies and inflammatory retinochoroidopathy were noted to be the major etiologic factors of CNV in children. Among them, Best vitelliform macular dystrophy was the most common reason, which is in line with the study of Tapas et al ( 10 ). Furthermore, one of the strengths of our study is the findings concerning the distribution of etiology.…”

Section: Discussionsupporting

confidence: 90%

“…In this study including 33 eyes of 30 pediatric patients with CNV, at least 1 contributing etiology could be identified in 25/33 (75.8%) eyes of the patients. A study by Tapas et al demonstrated that retinal dystrophies had the leading ocular correlation with CNV in pediatric patients younger than 18 years ( 10 ). In our series, identifiable ocular association could not be found in only 8/30 (26.7%) patients, whereas congenital/developing anomalies and inflammatory retinochoroidopathy were noted to be the major etiologic factors of CNV in children.…”

Section: Discussionmentioning

confidence: 99%

“…So far, very limited published data have reported the etiologic factors, clinical characteristics, natural history, and treatment outcomes of CNV in pediatric patients, and the observed subjects were mostly Western ( 10 ). Hence, we performed this study to investigate the etiologic factors, clinical characteristics, and treatment outcomes of CNV in Chinese pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

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Choroidal Neovascularization in Pediatric Patients: Analysis of Etiologic Factors, Clinical Characteristics and Treatment Outcomes

et al. 2021

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Background and Objectives: Choroidal neovascularization (CNV) is a common pathologic lesion that occurs in various chorioretinopathy, but very limited published data have reported in pediatric patients. This study aimed to investigate the etiologic factors, clinical features, and treatment outcomes of choroidal neovascularization (CNV) in children.Methods: In this study, 33 eyes in 30 patients aged 18 years or younger with CNV were included. Comprehensive ophthalmic examination was performed in all the patients. The demographic profiles, laterality, visual acuity, optical coherence tomographic findings, fundus fluorescein angiographic findings, and the underlying pathology were analyzed. The types, locations, treatment outcomes, and recurrences of CNV were noted.Results: The average age was 11.2 ± 4.6 (range, 1–18) years. Most CNVs affecting children were classic and type 2. The most common etiologic factors of CNV in pediatric patients were congenital/developing abnormalities (9/30, 30.0%) and inflammatory retinochoroidopathy (9/30, 30.0%), followed by idiopathic CNV (8/30, 26.7%). Subtype analysis showed that the etiologic factor was inflammatory retinochoroidopathy in children 12 years or older, whereas congenital/developing abnormalities were present in children younger than 12 years. Eyes with active CNVs required a mean of 1.40 ± 0.58 injections. No recurrence was observed during follow-up.Conclusions: The etiologic factors of CNV in young Chinese patients were diverse, with congenital/developing abnormalities, inflammatory retinochoroidopathy and idiopathic CNV being the 3 most common ones. Eyes with active CNVs had good responses to antivascular endothelial growth factor treatment with low recurrence.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Choroidal Neovascularization in Pediatric Patients: Analysis of Etiologic Factors, Clinical Characteristics and Treatment Outcomes

et al. 2021

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“…In literature, there are limited number of large studies which give insight on the etiology, and natural history of CNV in pediatric and adolescent age-group with treatment outcomes following anti-VEGF injections (Table 3). Till now, Kozak et al, 9 Henry et al 10 and Padhi et al 11 have published the large multicentric studies on pediatric CNV treated with anti-VEGF. The study published by Rishi et al 8 is the largest single-centre series on pediatric CNV, however, they used TTT and PDT as a primary treatment modality as majority of eyes were treated in the pre anti-VEGF era.…”

Section: Discussionmentioning

confidence: 99%

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

Ranjan

Salian

Verghese

et al. 2021

European Journal of Ophthalmology

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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.

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“…Some measurements obtained, mostly from the fovea, could potentially be used to screen for conditions like ROP (132). HH-OCT-A in specific is extremely useful in cases of CNV in children, such as ROP, retinal dystrophies, inflammatory disorders, trauma or cases of unexplained visual loss (134)(135)(136). Ocular measurements, specifically RNFL thickness, have been shown to be associated with systemic health conditions in infants (low birth weight, sepsis, and necrotizing enterocolitis) (137).…”

Section: Handheld Optical Coherence Tomographymentioning

confidence: 99%

The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques

et al. 2022

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The field of ophthalmic imaging has grown substantially over the last years. Massive improvements in image processing and computer hardware have allowed the emergence of multiple imaging techniques of the eye that can transform patient care. The purpose of this review is to describe the most recent advances in eye imaging and explain how new technologies and imaging methods can be utilized in a clinical setting. The introduction of optical coherence tomography (OCT) was a revolution in eye imaging and has since become the standard of care for a plethora of conditions. Its most recent iterations, OCT angiography, and visible light OCT, as well as imaging modalities, such as fluorescent lifetime imaging ophthalmoscopy, would allow a more thorough evaluation of patients and provide additional information on disease processes. Toward that goal, the application of adaptive optics (AO) and full-field scanning to a variety of eye imaging techniques has further allowed the histologic study of single cells in the retina and anterior segment. Toward the goal of remote eye care and more accessible eye imaging, methods such as handheld OCT devices and imaging through smartphones, have emerged. Finally, incorporating artificial intelligence (AI) in eye images has the potential to become a new milestone for eye imaging while also contributing in social aspects of eye care.

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Choroidal neovascular membrane in paediatric patients: clinical characteristics and outcomes

Abstract: Paediatric CNVMs in this series differed from those in the adult population with regard to aetiology, OCT and angiographic characteristics, treatment response and rate of recurrence.

Cited by 17 publications

References 18 publications

Choroidal Neovascularization in Pediatric Patients: Analysis of Etiologic Factors, Clinical Characteristics and Treatment Outcomes

Choroidal Neovascularization in Pediatric Patients: Analysis of Etiologic Factors, Clinical Characteristics and Treatment Outcomes

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

The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques

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