Role of anti-TNF in Pediatric Inflammatory Choroidal Neovascularization: A Case Series

Figures & data

Table 1. Baseline characteristics, management, and visual outcomes of 3 pediatric patients with CNV

Characteristics	Patient 1	Patient 2	Patient 3
Age (y)	5	5	8
Sex	F	M	F
Eye	OD//OS	OD	OD//OS
Initial BCVA	20/63 // 20/100	20/200	20/63 // 20/63
Location of CNV	Juxta- foveal	Juxta- foveal	IPM // Subfoveal
Anti-VEGF agent	Bevacizumab	Bevacizumab	Bevacizumab
Systemic treatment	IV + oral steroids+ MTX + Infliximab (Remicade)	IV + oral steroids+ MTX + Adalimumab (Humira)	IV + oral steroids+ MTX + Adalimumab (Humira)
Number of IVT Complications	14 // 3 Psoriasis	5 None	4 // 1 Psoriasis Elevated IOP ODG
Follow-up	48 Months	71 months	32 months
Final BCVA	20/20// 20/200	20/32	20/20 // 20/32

M, male; F, female; OD, right eye; OS, left eye; BCVA, best-corrected visual acuity; CNV, Choroidal neovascularization; VEGF, vascular endothelial growth factor; IV, intravenous; MTX, methotrexate; IPM, interpapillomacular; IVT, intravitreal therapy; IOP, intraocular pressure

Figure 1. Fundus color photography of patient 1 demonstrated parafoveal fibroglial scars on OD (A) and foveal fibroglial lesions on OS (B). Note the presence of subretinal hemorrhages (arrows) suggestive of CNV.

Figure 2. (A) (B) FA OD demonstrated hyperfluorescence in the early frames and late frames of CNV (yellow arrows). Note the fibroglial scars have constant hyperfluorescence. Late frame ICGA in OS (C), revealed numerous hypofluorescent spots corresponding to choroidal nodules.

Figure 3. SD OCT (A) (B) demonstrated subretinal fibrosis, serous detachment and cystoid formations corresponding pre-epithelial choroidal neovascularization. OS (B) presence of additional macular atrophy.

Figure 4. OCT A (A) shows CNV in the choriocapillaris layer on OS. (B) B Scan demonstrated persistent flow in CNV.