Efficiency of antiangiogenic therapy for choroidal neovascularization in children

Abstract

Choroidal neovascularization (CNV) in children is a rare but functionally significant complication of a wide range of fundus diseases. Data on the effectiveness of antiangiogenic therapy for CNV of various etiologies in ophthalmopediatrics are scarce.Purpose of the study is to analyze the effectiveness of antiangiogenic therapy for CNV in children.Material and methods. A retrospective analysis of the results of treatment of active CNV was performed in 54 children (59 eyes). All patients underwent intravitreal injection of antiangiogenic drug (ranibizumab, aflibercept or brolucizumab). In addition to standard ophthalmologic examination, children underwent optical coherence tomography (OCT) and OCT angiography (OCTA) of the macular area and optic nerve head at diagnosis and dynamically after treatment.Results. In 51 children (56 eyes), persistent suppression of CNV activity was achieved, in 3 children the drug administration was continued on an “as needed” basis. The number of anti-VEGF drug injections ranged from 1 to 7 (on average, 1.6 ± 1.3), while 8 children (8 eyes, 13.6 %) required more than 2 injections of the drug, in 6 of them the main disease was inflammatory lesion of the uveal tract and retina. The best corrected visual acuity in 20 children (20 eyes, 33.9 %) increased by 0.03–0.4, in 30 children (35 eyes, 59.3 %) it remained stable, in 4 children (4 eyes, 6.8 %) it decreased by 0.05–0.6. Conclusion. Anti-VEGF therapy is an effective method for treating CNV in children. Further studies are needed to identify risk factors and develop treatment regimens for refractory cases of CNV.