Visual outcome after surgical removal of choroidal neovascularization in pediatric patients

Objective: To assess the visual outcome after surgical removal of choroidal neovascularization (CNV) in pediatric patients. Methods: A retrospective, noncomparative, consecutive case series of 17 eye s undergoing surgical removal of CNV of various causes in patients aged 18 years and younger. Results: The cause of the CNV was presumed ocular histoplasmosis syndrome i n 11 eyes, idiopathic in 3, and optic nerve coloboma, ocular toxoplasmosis, and trauma in 1 eye each. Two eyes had CNV within 100 pm of the center of the foveal avascular zone (juxtafoveal CNV) and I eye had peripapillary CNV , while 14 eyes had CNV beneath the geometric center of the foveal avascula r zone (subfoveal CNV). In eyes with subfoveal CNV, median preoperative Sne llen visual acuity was 20/200 (range, 20/80-3/200). With a median follow-up of 27 months (range, 6-45 months), median final visual acuity was 20/50 (r ange, 20/20-2/200); 10 (72%) had improvement of 2 or more Snellen lines aft er surgery, and 6 eyes (43%) had final visual acuity of 20/40 or better. In 3 eyes with juxtafoveal CNV or peripapillary CNV, all eyes had improvement of 4 or more Snellen lines. Postoperative recurrent CNV developed in 6 (35 %) of 17 patients; 2 of the eyes underwent a second vitrectomy and 4 receiv ed laser treatment for the recurrences. Conclusions: Pediatric patients may have good recovery of vision after surg ical removal of CNV, and the removal of these membranes may be. a viable al ternative to laser photocoagulation in pediatric patients.