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Choroidal neovascular membrane in paediatric patients: clinical characteristics and outcomes
  1. Tapas Ranjan Padhi1,
  2. Bradley J Anderson2,
  3. Ashkan M Abbey2,
  4. Yoshihiro Yonekawa2,
  5. Maxwell Stem2,
  6. Danish Alam1,
  7. Rohit Ramesh Modi1,
  8. Laxmi Prabhavathi Savla1,
  9. Michael T Trese2,
  10. Antonio Capone2,
  11. Kimberly A Drenser2,
  12. Cagri G Besirli3
  1. 1Retina and Vitreous, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
  2. 2Associated Retinal Consultants, Royal Oak, Michigan, USA
  3. 3Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Cagri G Besirli, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI 48109, USA; cbesirli{at}umich.edu

Abstract

Purpose To analyse the clinical characteristics and treatment outcomes of choroidal neovascular membranes (CNVM) in paediatric subjects at three paediatric retina referral centres.

Methods Medical charts of patients aged 18 years or less with a diagnosis of CNVM were retrospectively reviewed. The demographic profile, laterality, presenting complaint, corrected vision, underlying pathology, fundus, fundus fluorescein angiogram and optical coherence tomogram (OCT) were analysed. CNVM type, frequency, treatment indications, recurrences and final visual acuity were noted.

Results There were a total of 35 subjects (43 eyes) with a mean age of 11.2 years. The CNVMs were mostly type 2 (90.0%), classic (90.9%), subfoveal (59.09%) and active (84.1%). Best vitelliform macular dystrophy was found to be the most common association (32.5%). Intravitreal injection of an anti-vascular endothelial growth factor (VEGF) agent was the initial therapy of choice in all. Eyes with CNVMs responsive to anti-VEGF alone required a mean of 2.11 injections. Patients with recurrent disease (21.21%) had an average of 1.14 episodes per eye. While 50% of recurrent CNVMs stabilised with repeat anti-VEGF treatment, the remaining patients required photodynamic therapy, laser or surgery.

Conclusion Paediatric CNVMs in this series differed from those in the adult population with regard to aetiology, OCT and angiographic characteristics, treatment response and rate of recurrence.

  • choroid
  • retina
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Footnotes

  • Annual conference, ARVO, Denver, Colorado, 2015; Annual conference, ARVO, Seattle, WA, 2016.

  • Contributors TRP: concept and design of the work; worked under the guidance of the corresponding author throughout in drafting the original to the revised version; acquisition, analysis and interpretation of data; preparation of tables and figures; compiling and checking the references; revision and approval of the original and revised versions. BJA: concept and design of the work; acquisition, analysis and interpretation of data; drafting the work; revision and approval of the original and revised versions. AMA, KAD: concept and design of the work; analysis and interpretation of data; drafting the work; revision and approval of the original and revised versions. YY, MS, RRM: assistance in the design of the work; acquisition, interpretation of data and statistical analysis; revision and approval of the original and revised versions. DA: assistance in the concept and design of the work; acquisition, analysis and interpretation of data; drafting the work; revision and approval of the original and revised versions. LPS: assistance in the design of the work; data acquisition, analysis and interpretation; drafting the work; preparation of tables and figures; revision and approval of the original and revised versions. MTT: concept and design of the work; analysis and interpretation of data; drafting the work; editing and revision to improve the intellectual content; approval of the original and revised versions. AC: concept and design of the work; critical analysis and interpretation of data; editing and revision; approval of the original and revised versions. CGB: initial concept and design of the work; guiding the first author throughout from initial draft to the final and revised version; assembled all the information and critical analysis of the draft prepared by the first author and all coauthors; edited and re-edited the drafts to increase the intellectual content; final correction and adjustment of tables and figures; correction and approval of the references; final approval of the original and revised versions. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Ethics approval Institutional Review Board of LV Prasad Eye Institute, Bhubaneswar, India, and Institutional Review Board of Kellogg Eye Center, University of Michigan.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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