Intravitreal ranibizumab treatment in choroidal neovascularization secondary to ocular toxoplasmosis in children

Abstract

Purpose Choroidal neovascularization associated to ocular toxoplasmosis is a known complication of the disease. The important role that the intravitreal anti‐VEGF therapy plays on the CNV has been well‐established. Also, the efficacy of the treatment in CNV secondary to ocular toxoplasmosis in adult patients it has been long described, however there are not cases reported in young patients. The purpose is to describe the efficacy of intravitreal ranibizumab in CNV secondary to ocular toxoplasmosis in children. Methods We present the case of an 8‐year‐old patient with history of ocular toxoplasmosis comes to the hospital with a sudden loss of visual acuity in the right eye (BCVA: 20/200). The fundoscopy shows an old toxoplasmosis scar associated with new perilesional hemorrhages and macular edema. We confirmed these lesions with a SS‐OCT which demonstrated the subretinal fluid associated with a RPE disruption and foveal fibrosis. CNV presence was suggested due to these retinal changes and we decided to treat with intravitreal injections of ranibizumab and anti‐parasitic treatment. Results After three injections of ranibizumab and 6 months of follow up, all the CNV signs have disapeared and the patient has a good recovery of the visual acuity (BCVA: 20/25). Conclusions Intravitreal ranibizumab may be an effective treatment in CNV secondary to ocular toxoplasmosis also in children. In our case, three injections of ranibizumab controlled the secondary CNV, however it is necessary long‐term studies to determinate the effectivity and frequency of the treatment in these patients.