Russian Pediatric OphthalmologyRussian Pediatric OphthalmologyРоссийская педиатрическая офтальмология1993-18592412-432XEco-Vector62552510.17816/rpoj625525Original study articleОригинальные исследованияResearch ArticleChoroidal neovascularization in children: Etiology, diagnosis, and clinical manifestationsХориоидальная неоваскуляризация у детей: этиология, диагностика и клинические проявленияhttps://orcid.org/0000-0002-4857-0374KatarginaLyudmila A.КатаргинаЛюдмила Анатольевна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д.м.н., профессор

katargina@igb.ruhttps://orcid.org/0000-0003-3735-62494111-4330DenisovaEkaterina V.ДенисоваЕкатерина Валерьевна
Russian Federation

MD, Cand. Sci. (Medicine)

к.м.н.

deale_2006@inbox.ruhttps://orcid.org/0000-0002-3151-69105872-6819OsipovaNatalya A.ОсиповаНаталья Анатольевна
Russian Federation

MD, Cand. Sci. (Medicine)

к.м.н.

natashamma@mail.ruKiselevaYana A.КиселеваЯна Андреевна
Russian Federation

resident doctor

врач ординатор

drkiseleva@inbox.ruHelmholtz National Medical Research Center of Eye DiseasesНМИЦ глазных болезней им. Гельмгольца050420241915141001202425012024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://ruspoj.com/1993-1859/article/view/625525

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.

Исследования, посвящённые анализу хориоидальной неоваскуляризации (ХНВ) у детей, носят ограниченный характер вследствие низкой частоты развития данного осложнения в офтальмопедиатрии. Однако, учитывая значимое влияние на остроту зрения и трудности диагностики у детей, изучение данного осложнения является актуальным.

Цель. Анализ этиологической структуры и клинических особенностей хориоидальной неоваскуляризации у детей.

Материал и методы. За период 2014–2022 гг. под нашим наблюдением находилось 54 ребёнка (26 девочек и 28 мальчиков), 61 глаз с ХНВ. Помимо стандартного офтальмологического обследования пациентам проводилась оптическая когерентная томография (ОКТ) и ОКТ-ангиография (ОКТА) макулярной зоны и диска зрительного нерва на томографе RS-3000 Advance 2, Nidek (Япония).

Результаты. Возраст детей на момент диагностирования ХНВ составил от 5 до 17 лет (в среднем 11±3 лет). У 30 детей (55,6%) ХНВ сформировалась вследствие воспалительного поражения сетчатки и хориоидеи, из них у 11 — в период ремиссии, у 21 — на фоне патологии сетчатки, хориоидеи и зрительного нерва невоспалительного генеза (у 8 из них — на фоне болезни Беста), у 3 детей ХНВ была расценена как идиопатическая. Срок развития поствоспалительной ХНВ варьировал от 1 месяца до 12 лет, в среднем 7,3±5 месяцев от дебюта заболевания. В большинстве случаев (48 глаз, 78,7%) определялась ХНВ тип 2.

Заключение. Хориоидальная неоваскуляризация является редким осложнением широкого спектра заболеваний глазного дна у детей. В нашей когорте её развитие наиболее часто наблюдалось на фоне воспалительного поражения сетчатки и хориоидеи, в том числе в стадии ремиссии. Разные сроки формирования ХНВ требуют активного мониторинга пациентов с риском её развития.

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