Inflammatory Choroidal Neovascularization in Pediatric Uveitis: A Case Series
Amandine Gauderon1, Chiara Eandi2, Aikaterini Koryllou3
1Jules-Gonin Eye Hospital, FAA, Uveitis Clinic, Department of Ophthalmology, University of Lausanne, Switzerland.
Insights
Anti-VEGF therapy is safe and effective for treating choroidal neovascularization (CNV) in children with uveitis. Minimal injections are needed, and treating the underlying inflammation is key for good outcomes.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Inflammatory Eye Disease
Background:
- Choroidal neovascularization (CNV) in children is often secondary to ocular inflammation, such as uveitis.
- Understanding the clinical features, treatment, and outcomes of pediatric inflammatory CNV is crucial for effective management.
Purpose of the Study:
- To describe the clinical characteristics, therapeutic interventions, and outcomes of children diagnosed with inflammatory choroidal neovascularization (CNV).
Main Methods:
- A retrospective case series was conducted involving children diagnosed with macular CNV secondary to ocular inflammation.
- Data were collected from patients seen at a specialized eye hospital between 2000 and 2024.
Main Results:
- Four children with inflammatory CNV were identified, presenting with unilateral disease after uveitis onset.
- Treatments included oral steroids, adalimumab, antibiotics, and anti-VEGF injections, with generally good visual acuity outcomes.
- No CNV recurrence was observed, even with uveitis reactivation.
Conclusions:
- Anti-VEGF therapy demonstrates safety and efficacy in pediatric patients with inflammatory CNV, requiring minimal interventions.
- Effective management necessitates addressing the underlying cause of uveitis alongside CNV treatment.
Background:
The aim of our study is to describe clinical features, therapy, and outcome of children with inflammatory choroidal neovascularization (CNV).
Methods:
Retrospective case series of children seen at the Jules-Gonin Eye Hospital between 2000 and 2024 with macular choroidal neovascularisation secondary to ocular inflammation.
Results:
Four children (one male, three females) developed a retro-foveolar neovascular membrane after a median time of 2.5 months (range 1 - 16 months) following uveitis onset. The median age at presentation was 12 years (range 5 - 12 years). The CNV presentation was unilateral in all four cases, with three patients having posterior uveitis and one panuveitis. Two patients had idiopathic bilateral granulomatous uveitis while the other two had suspected toxoplasmosis chorioretinitis. Idiopathic cases were treated with oral steroids, with one patient being additionally treated with adalimumab. Toxoplasmosis cases were managed with antibiotics and oral steroids. CNV treatment involved a single anti-VEGF injection in two cases, six injections in one case, and no injection in one case due to CNV inactivity. Median follow-up period was 4.25 years (range 0.75 to 11 years) and the median final best-corrected visual acuity was 0.9 (range 0.6 - 1.25). No recurrence of CNV was observed, despite uveitis reactivation in two cases.
Conclusion:
Anti-VEGF therapy is safe even in young children with minimal injections required to control the disease. Treating the underlying cause of uveitis with appropriate therapy is also crucial.
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