Etiology and Treatment of Choroidal Neovascularization in Pediatric Patients

Abstract

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.

Active surveillance of choroidal neovascularisation in children: incidence, aetiology and management findings from a national study in the UK

“…In our study, the youngest presentation was seen in two female 4-year-olds with optic disc anomalies, but the majority of cases were in older children with a mean age at presentation of 11 years. The most common aetiologies were inflammatory disease, particularly multifocal choroiditis and optic disc anomalies, which is in concordance with Rishi and colleagues, whereas Barth et al 9 reported choroidal osteoma followed by hereditary macular dystrophy as the most common causes. Both studies reported that most CNVs were subfoveal.…”

“…The disorder is rare with an annual incidence in the UK for those aged 16 and under of 0.21 per 100 000. Two retrospective studies of CNV in children younger than 18 years2 9 reported opposing gender preponderance, with Barth et al 9 reporting a strong female predominance (80%), in contrast to Rishi et al, 2 who described a higher male preponderance (63%). This result may be due to the different ethnic background and access to healthcare facilities.…”

Long-Term Natural Course of Pathologic Myopia in Chinese Patients

“…In comparison with the deteriorated UCVA in adult pathological myopes, UCVA and BCVA in PM children improved during the follow-up period. Posterior staphyloma and fundus degenerations are not common in highly myopic children [30], but the incidence and severity of pathological changes in high myopia increase with age [31]. The improvement of visual acuity in highly myopic children may be resulted from ongoing visual development as well as mild pathological features.…”

Diffuse subretinal fibrosis syndrome: A rare entity

“…Symeonidis et al 10 reported a case of diffuse subretinal fibrosis and uveitis syndrome without neovascularization in a 52-year-old male who was treated with intravenous followed by oral steroids associated with three injections of ranibizumab; there was no significant visual recovery. Barth et al 13 studied the outcome of different treatments of choroidal neovascularization in children; one girl with choroidal neovascularization secondary to punctuate inner choroidopathy was treated by one injection of bevacizumab but showed recurrence after 7 months. In their study, they also reported the use of photodynamic therapy in choroidal neovascularization of other causes (idiopathic and high myopia) with partial results.…”