Choroidal neo-vascular membrane in a paediatric optic disc pit: A case report

Ahmad Alshammari 1, Talal Alabduljalil 2

Affiliations

12 November 2022

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doi: 10.1016/j.ajoc.2022.101751

Abstract

Purpose: To report a paediatric patient with unilateral optic nerve pit found to have choroidal neo-vascular membrane in the same eye.

Observation: An 8-year old girl known to have a unilateral optic nerve pit presented with exotropia of the right eye. On examination, her vision was 20/40; sub-retinal haemorrhage was noted on clinical fundus exam and a sub retinal vascular net was confirmed on optical coherence tomography angiography.

Conclusion and importance: The unusual finding of a choroidal neo-vascular membrane in a known optic nerve pit case represents a new finding of a possible complication. Patients with optic nerve pit may be considered as candidates for OCT-angiography for further diagnosis and proper treatment leading to improved vision, care and prognosis.

Keywords: Choroidal neo-vascular membrane; Optic disc pit.

Conflict of interest statement

We declare no potential conflict of interest with respect to research, authorship and/or publication of this article.

Figures

Fig. 1 OCT at presentation showing sub-retinal fluid and sub-retinal hyper-reflective material.

Fig. 1 OCT at presentation showing sub-retinal fluid and sub-retinal hyper-reflective material.

Fig. 2 OCT 3-weeks post Anti-VEGF injection showing resolution of the sub-retinal fluid.

Fig. 2 OCT 3-weeks post Anti-VEGF injection showing resolution of the sub-retinal fluid.

Fig. 3 OCT 67-weeks post Anti-VEGF injection showing stable treatment response.

Fig. 3 OCT 67-weeks post Anti-VEGF injection showing stable treatment response.

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KMEL References

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References

  1.  
    1. Wiethe T. Ein fall von angeborener deformität der sehnervenpapille. Arch Augenheilkd. 1882;11:14–19.
  2.  
    1. Brown G.C., Tasman W. Grune & Stratton; New York: 1983. Congenital Anomalies of the Optic Disc; pp. 95–192.
  3.  
    1. Ferry A.P. Macular detachment associated with congenital pit of the optic nerve head. Pathologic findings in two cases simulating malignant melanoma of the choroid. Arch Ophthalmol. 1963 Sep;70:346–357. - PubMed
  4.  
    1. Irvine A.R., Crawford J.B., Sullivan J.H. The pathogenesis of retinal detachment with morning glory disc and optic pit. Retina. 1986;6(3):146–150. Summer-Fall. - PubMed
  5.  
    1. Ohno-Matsui K., Hirakata A., Inoue M., Akiba M., Ishibashi T. Evaluation of congenital optic disc pits and optic disc colobomas by swept-source optical coherence tomography. Invest Ophthalmol Vis Sci. 2013 Nov 25;54(12):7769–7778. - PubMed
  6.  
    1. Giansanti F., Virgili G., Varano M., et al. Photodynamic therapy for choroidal neovascularization in pediatric patients. Retina. 2005 Jul-Aug;25(5):590–596. - PubMed
  7.  
    1. Rishi P., Venkataraman A., Rishi E. Combination photodynamic therapy and bevacizumab for choroidal neovascularization associated with toxoplasmosis. Indian J Ophthalmol. 2011 Jan-Feb;59(1):62–64. doi: 10.4103/0301-4738.73728. - DOI - PMC - PubMed
  8.  
    1. Avery R.L. Extrapolating anti-vascular endothelial growth factor therapy into pediatric ophthalmology: promise and concern. J AAPOS. 2009 Aug;13(4):329–331. - PubMed
  9.  
    1. Sivaprasad S., Moore A.T. Choroidal neovascularisation in children. Br J Ophthalmol. 2008 Apr;92(4):451–454. - PubMed
  10.  
    1. Rishi P., Gupta A., Rishi E., Shah B.J. Choroidal neovascularization in 36 eyes of children and adolescents. Eye. 2013 Oct;27(10):1158–1168. - PMC - PubMed
  11.  
    1. Kohly R.P., Muni R.H., Kertes P.J., Lam W.C. Management of pediatric choroidal neovascular membranes with intravitreal anti-VEGF agents: a retrospective consecutive case series. Can J Ophthalmol. 2011 Feb;46(1):46–50. - PubMed
  12.  
    1. Kozak I., Mansour A., Diaz R.I., et al. King khaled eye specialist hospital international collaborative retina study group. Outcomes of treatment of pediatric choroidal neovascularization with intravitreal antiangiogenic agents: the results of the KKESH international collaborative retina study group. Retina. 2014 Oct;34(10):2044–2052. - PubMed
  13.  
    1. Spaide R.F. Choroidal neovascularization in younger patients. Curr Opin Ophthalmol. 1999 Jun;10(3):177–181. - PubMed
  14.  
    1. Cohen S.Y., Laroche A., Leguen Y., Soubrane G., Coscas G.J. Etiology of choroidal neovascularization in young patients. Ophthalmology. 1996 Aug;103(8):1241–1244. - PubMed
  15.  
    1. Bertoli F., Pignatto S., Rizzetto F., Lanzetta P. A 5-year-old case of choroidal neovascularization in enhanced S-cone syndrome treated with ranibizumab. Case Rep Ophthalmol. 2018 Dec 21;9(3):510–515. - PMC - PubMed

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