Response of Pediatric Choroidal Neovascularization to Anti-Vascular Endothelial Growth Factor

Abstract

Choroidal neovascularization (CNV) is a rare condition in children but poses a substantial threat to vision. Anti-vascular endothelial growth factor (anti-VEGF) therapy is commonly used in the pediatric population to treat retinopathy of prematurity. However, the use of anti-VEGF is less common for childhood CNV due to the rarity of CNV in the pediatric population. We report the case of a 10-year-old male presenting with an idiopathic choroidal neovascular membrane. Following a relapse of subretinal fluid after photodynamic therapy, anti-VEGF (bevacizumab) was injected and resulted in remission of the neovascular membrane and improved visual outcome. Further studies are required to elucidate the long-term outcomes associated with the use of anti-VEGF in pediatric patients.

Keywords: anti-vegf; choroidal neovascular membrane; ophthalmology; pediatric ophthalmology; retina.

Figure 1. Fundus photo (A) showing subfoveal choroidal neovascular membrane and optical coherence tomography (B) demonstrating the presence of subretinal and intraretinal fluid.

Figure 2. Pre-photodynamic therapy with CRT 350 µm (A) and post-photodynamic therapy with CRT 330 µm (B) of the right eye.

CRT, central retinal thickness.

Figure 3. Pre-bevacizumab optical coherence tomography with CRT 409 µm (A) and optical coherence tomography angiography (B) of the right eye.

CRT, central retinal thickness.

Figure 4. Optical coherence tomography 10 months post-bevacizumab with CRT 289 µm (A) and 16 months post-bevacizumab with CRT 287 µm (B) of the right eye.

CRT, central retinal thickness.