Igor Kozak1, Ahmad Mansour, Rocio I Diaz, Jorge I Calzada, Francesco Pichi, Vanessa Cruz-Villegas, Manuel Diaz-Llopis, Roberto Gallego-Pinazo, Jay Chhablani, Mauricio Martinez-Cartier, Martin Meerhoff, William F Mieler, J Fernando Arevalo. 1. *Ophthalmology Service, Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; †Department of Ophthalmology, Professor Albrecht Meerhoff Clinic, American University of Beirut, Beirut, Lebanon; ‡Charles Retina Institute, Memphis, Tennessee; §San Giuseppe Hospital, University Eye Clinic, Milan, Italy; ¶Department of Ophthalmology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico; **University of Valencia School of Medicine, and Department of Ophthalmology, Hospital Universitario La Fe de Valencia, Valencia, Spain; ††L. V. Prasad Eye Institute, Hyderabad, India; ‡‡Servicio de Oftalmologia, Instituto de la Vision, Hospital Universitario Austral, Buenos Aires, Argentina; §§Clinica Professor Albrecht Meerhoff, Montevideo, Uruguay; ¶¶Department of Ophthalmology and Visual Sciences, University of Chicago at Illinois, Chicago, Illinois; and ***Retina Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
Abstract
PURPOSE: To evaluate safety and clinical results of intravitreal antiangiogenic agents for choroidal neovascularization in pediatric patients. METHODS: Retrospective, multicenter, interventional case series. A total of 45 eyes of 39 pediatric patients with choroidal neovascularization of various etiologies were treated with intravitreal injection of antiangiogenic agents (1.25 mg per 0.05 mL of bevacizumab or 0.5 mg per 0.05 mL of ranibizumab). RESULTS: There were 24 girls and 15 boys with group median age of 13 years (range, 3-17 years). Mean follow-up period was 12.8 months (range, 3-60 months). Median visual acuity in terms of logarithm of the minimum angle of resolution at presentation and last follow-up was 0.87 and 0.7, respectively (P = 0.0003). Mean and median number of injections received over the follow-up period was 2.2 and 1, respectively. At the last follow-up, 22 eyes (48%) gained more than 3 lines of vision and 27 eyes (60%) had final visual acuity 20/50 or better. Nine eyes (20%) did not improve and had severe vision loss (20/200 or worse). CONCLUSION: Intravitreal antiangiogenic therapy for choroidal neovascularization in pediatric patients seems temporarily safe and effective in majority of affected eyes. Because of the rarity and character of this condition, it is unlikely that any clinical trials will soon take place to study this or other treatment option.
PURPOSE: To evaluate safety and clinical results of intravitreal antiangiogenic agents for choroidal neovascularization in pediatric patients. METHODS: Retrospective, multicenter, interventional case series. A total of 45 eyes of 39 pediatric patients with choroidal neovascularization of various etiologies were treated with intravitreal injection of antiangiogenic agents (1.25 mg per 0.05 mL of bevacizumab or 0.5 mg per 0.05 mL of ranibizumab). RESULTS: There were 24 girls and 15 boys with group median age of 13 years (range, 3-17 years). Mean follow-up period was 12.8 months (range, 3-60 months). Median visual acuity in terms of logarithm of the minimum angle of resolution at presentation and last follow-up was 0.87 and 0.7, respectively (P = 0.0003). Mean and median number of injections received over the follow-up period was 2.2 and 1, respectively. At the last follow-up, 22 eyes (48%) gained more than 3 lines of vision and 27 eyes (60%) had final visual acuity 20/50 or better. Nine eyes (20%) did not improve and had severe vision loss (20/200 or worse). CONCLUSION: Intravitreal antiangiogenic therapy for choroidal neovascularization in pediatric patients seems temporarily safe and effective in majority of affected eyes. Because of the rarity and character of this condition, it is unlikely that any clinical trials will soon take place to study this or other treatment option.
Authors: Chiara Veronese; Chiara Maiolo; David Huang; Yali Jia; Grayson W Armstrong; Mariachiara Morara; Antonio P Ciardella Journal: Am J Ophthalmol Case Rep Date: 2016-04-20