Inflammatory Choroidal Neovascularization in Pediatric Uveitis: A Case Series.

Abstract

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.