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Choroidal neovascularization in 111 eyes of children and adolescents

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Abstract

Purpose

To describe the clinical features, management, and outcomes of choroidal neovascularization (CNV) in children less than 18 years of age.

Methods

This was a retrospective, case control study of 111 eyes of 96 patients. CNV was clinically diagnosed in all patients. Eyes were classified as those that were observed (Controls; Group 1) or those that had treatment (Cases; Group 2). CNV was categorized as regressed, persistent, or recurrent in order to evaluate the anatomical outcomes.

Results

Of 96 patients, 68(71%) were male. Mean presenting age was 11.4 ± 3.4 years (median = 11 years, range = 1–17 years). CNV was bilateral in 15(16%) patients. Of 111 eyes, 38 eyes had treatment (Cases) and 73 eyes did not (Natural history group or Controls). Subfoveal CNV was seen in majority of cases (59%). Most common etiology was post-inflammatory (38%), followed by trauma (16%). Eyes were classified as those that were observed (controls; Group 1) or those that had treatment (cases; Group 2). In group 1, spontaneous regression of CNV was seen in 26(36%) eyes and there was no recurrence in this group. In group 2 following treatment, 25(66%) of 38 eyes achieved complete regression at mean 4.9 months and was persistent in 5 eyes. CNV recurrence was seen in 10 eyes with the mean time to first recurrence being 9 months. At presentation, mean best-corrected visual acuity (BCVA) of eyes with subfoveal CNV was logMAR 0.99 that improved to logMAR 0.63 with treatment. Mean follow-up was 17 months.

Conclusion

CNV results in significant visual decline in children; most commonly of post-inflammatory etiology. Treatment achieves high regression rates, albeit with limited visual improvement.

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Data availability

The data pertaining to this research can be submitted upon request from the corresponding author.

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Funding

No funding was received for this research. The authors declare no financial interest.

Author information

Author notes

  1. Pukhraj Rishi, Rekha Priya Kalluri Bharat and Ekta Rishi have contributed equally to this work.

Authors and Affiliations

  1. Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18 College Road, Chennai, Tamilnadu, 600006, India

    Pukhraj Rishi, Rekha Priya Kalluri Bharat, Ekta Rishi & Muna Bhende

  2. Department of Uvea, Sankara Nethralaya, 18 College Road, Chennai, Tamilnadu, 600006, India

    Jyotirmay Biswas, Arshee Ahmed & Sridharan Sudharshan

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  1. Pukhraj Rishi
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  2. Rekha Priya Kalluri Bharat
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  3. Ekta Rishi
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  4. Muna Bhende
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for the Sankara Nethralaya Vitreoretinal Study Group

Contributions

Conceptualization and Methodology PR, Formal analysis and investigation PR, RPKB, ER, Writing—original draft preparation RKB, Writing—review and editing PR, RPKB, ER, MB, JB, AA, SS.

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Correspondence to Pukhraj Rishi.

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IRB approval was obtained (Ethics subcommittee, Vision Research Foundation, Chennai, India. 20190810). The authors declare that they have no ethical conflicts to disclose.

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Rishi, P., Bharat, R.P.K., Rishi, E. et al. Choroidal neovascularization in 111 eyes of children and adolescents. Int Ophthalmol 42, 157–166 (2022). https://doi.org/10.1007/s10792-021-02018-2

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  • DOI: https://doi.org/10.1007/s10792-021-02018-2

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