J Retin.  2023 May;8(1):15-22. 10.21561/jor.2023.8.1.15.

Clinical Features of Pediatric Choroidal Neovascularization and Outcomes of Treatment with Intravitreal Anti-VEGF in Korean Patients

• Choi SI
• Hwang S
• Kang SW
• Kim SJ

• KMID: 2552110
• DOI: http://doi.org/10.21561/jor.2023.8.1.15

Abstract

Purpose
To analyze the clinical features of pediatric choroidal neovascularization (CNV) and report the outcomes of treatment with intravitreal anti-vascular endothelial growth factor (VEGF) in Korean patients.
Methods
Patients aged 18 years or younger and diagnosed with CNV were studied retrospectively. We assessed best corrected visual acuity (BCVA), type and activity of CNV, changes of central macular thickness (CMT), recurrences, and complications after injection.
Results
In total, 15 CNV lesions were noted. At initial diagnosis, the average age of patients was 12.42 years (SD, 4.25; range, 4-18 years). The mean follow-up period was 34.6 months (range, 12-122 months). The causes of CNV were idiopathic (n = 7), inflammation (n = 2), tumor (n = 3), and trauma (n = 3). A total of 54 injections (average 4.15/eye) was administered for CNV. BCVA (logarithm of the minimum angle of resolution) improved significantly from 0.68 (SD, 0.3) before injection to 0.45 (SD, 0.4) after injection (Wilcoxon signed rank test, p < 0.05). CMT was 377.93 (SD, 132.2), 293.17 (SD, 109.8), and 315.20 (SD, 120.2) before the injection treatment, after one injection, and at last follow-up, respectively. There was leakage at the injection site due to a treatment complication in one eye (one of 54 injections).
Conclusions
In pediatric patients, CNV had a variety of causes. Intravitreal anti-VEGF treatment showed relatively good outcomes such as improved vision, but repeated injection was frequently required.

Keyword

Choroidal neovascularization; Intravitreal injection; Pediatric retinal disease; Vascular endothelial growth factor