Choroidal neovascularization in children: Etiology, diagnosis, and clinical manifestations

L. A. Katargina, E. Denisova, Natalya A. Osipova, Ya. A. Kiseleva
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Abstract

Few studies have analyzed choroidal neovascularization (CNV) in children because of the low incidence of this complication in pediatric ophthalmology. However, given the significant effect on visual acuity and diagnostic difficulties in children, the study of this complication is relevant. AIM: This study aimed to analyze the etiological structure and clinical features of CNV in children. MATERIAL AND METHODS: From 2014 to 2022, 61 eyes of 54 children (26 girls and 28 boys) had CNV. The patients underwent standard ophthalmologic examination and optical coherence tomography (OCT) and OCT angiography (OCTA) of the macular zone and optic disc using the RS-3000 Advance 2 Tomograph (Nidek, Japan). RESULTS: At the time of CNV diagnosis, the children were 5–17 years old, with a mean of 11±3 years. In 30 children (55.6%), CNV was caused by inflammatory lesions of the retina and choroid. Of these cases, 11 occurred during remission, whereas 21 occurred alongside pathologies of the retina, choroid, and optic nerve of noninflammatory genesis (8 of which were associated with Best’s disease). In three children, CNV was considered idiopathic. The development time of postinflammatory CNV ranged from 1 month to 12 years, with an average of 7.3±5 months from disease onset. Type 2 CNV was found in most cases (48 eyes, 78.7%). CONCLUSION: CNV is a rare complication of various ocular diseases in children. In our cohort, it was most frequently observed in children with inflammatory lesions of the retina and choroid, even during remission. Patients at risk of CNV must be actively monitored because it occurs in various forms.
儿童脉络膜新生血管:病因、诊断和临床表现
由于小儿眼科中脉络膜新生血管(CNV)的发病率较低,因此很少有研究对儿童脉络膜新生血管(CNV)进行分析。然而,鉴于脉络膜新生血管对儿童视力的重大影响以及诊断上的困难,对这一并发症的研究具有现实意义。目的:本研究旨在分析儿童 CNV 的病因结构和临床特征。材料与方法:2014 年至 2022 年,54 名儿童(26 名女孩和 28 名男孩)的 61 只眼睛患有 CNV。患者接受了标准眼科检查,并使用RS-3000 Advance 2断层成像仪(日本Nidek公司)对黄斑区和视盘进行了光学相干断层成像(OCT)和OCT血管成像(OCTA)。结果:确诊 CNV 时,患儿年龄为 5-17 岁,平均年龄为 11±3 岁。30名儿童(55.6%)的CNV是由视网膜和脉络膜的炎性病变引起的。在这些病例中,11 例发生在病情缓解期,21 例与视网膜、脉络膜和视神经的非炎症性病变同时发生(其中 8 例与贝斯特氏病有关)。有 3 名儿童的 CNV 被认为是特发性的。炎症后 CNV 的发展时间从 1 个月到 12 年不等,平均为 7.3±5 个月。大多数病例(48 只眼睛,78.7%)发现了 2 型 CNV。结论:CNV是儿童各种眼科疾病的罕见并发症。在我们的队列中,视网膜和脉络膜有炎症病变的儿童最常出现 CNV,即使在病情缓解期间也是如此。由于 CNV 的形式多种多样,因此必须积极监测有 CNV 风险的患者。
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