Pediatric peripapillary choroidal neovascularization secondary to ocular sarcoidosis: a long-term follow-up case

• Published in: BMC ophthalmology Vol. 25; no. 1; pp. 422 - 5
• Main Authors: Zong, Yuan, Wang, Keyan, Zhang, Ting, Xu, Gezhi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 23.07.2025; BioMed Central; BMC
• Subjects: Adalimumab; Adolescent; Angiogenesis Inhibitors - therapeutic use; Angiotensin; Anti-vascular endothelial growth factor; Antibodies; Biopsy; Case Report; Case reports; Choroidal neovascularization; Choroidal Neovascularization - diagnosis; Choroidal Neovascularization - drug therapy; Choroidal Neovascularization - etiology; Drug dosages; Enzymes; Fluorescein Angiography; Follow-Up Studies; Granulomatous uveitis; Humans; Immunomodulation; Immunosuppressive agents; Inflammation; Injections; Magnetic resonance imaging; Male; Medical imaging; Metabolism; Nasopharynx; Neovascularization; Patients; Pediatric; Pediatrics; Peptidyl-dipeptidase A; PET imaging; Positron emission tomography; Rheumatology; Sarcoidosis; Sarcoidosis - complications; Sarcoidosis - diagnosis; Sarcoidosis - drug therapy; Small intestine; Steroids; Tomography; Tomography, Optical Coherence; Uveitis; Vascular endothelial growth factor; Vascularization; Vasculitis; Visual acuity; Anti-vascular endothelial growth factor; Choroidal neovascularization; Sarcoidosis; Pediatric; Immunosuppressive agents; Uveitis
• DOI: 10.1186/s12886-025-04266-7
• ISSN: 1471-2415

To describe a 14-year-old male with probable ocular sarcoidosis and bilateral peripapillary choroidal neovascularization (PCNV). We report a case of a 14-year-old boy with a 2-month history of floaters and gradual vision loss in both eyes. Examination revealed bilateral granulomatous uveitis with peripapillary subretinal lesions. The serum angiotensin-converting enzyme was elevated. Positron emission tomography demonstrated increased metabolic activity in the nasopharynx and small intestine, consistent with diagnosis of sarcoidosis. Despite resolution of vitreous cells and retinal vasculitis, the PCNV progressed slowly in the left eye, which was controlled with combined treatment of immunomodulatory regiment and multiple intravitreal anti-vascular endothelial growth factor injections over a prolonged period. This case highlights the need for a multidisciplinary approach and long-term follow-up in pediatric ocular sarcoidosis with PCNV.