Advantages:

Identification of causes of macular edema and exudates in pediatric age group in important.

Methods:

Prospective case series. Pediatric macular edema and exudates provide definite challenges to the practicing ophthalmologist. We present a case series of pediatric macular edema and exudates related in 5 cases to the presence of peripheral retinal hemangioblastoma related to Von Hippel Lindau (VHL) disease and in 16 cases to retinal telangiectasia associated with Coats disease.

Management of ME associated with VHL included laser photocoagulation to the peripheral tealngiectasia in 3 cases, plaque brachytherapy in 1 case and cryotherapy in 1 case. ME regressed in all cases with gradual resolution of exudates.

In Coats disease, we used initially triamcinolone injection followed by peripheral laser photocoagulation one month later. This was associated with improvement in ME and exudates in 14 out of 16 patients.

Effectiveness / Safety:

ME in pediatric age group is a special challenge. Management strategies  for the treatment of peripheral lesions  include laser photocoagulation, cryoapplication, tiamcynolone  injection and brachytherapy.

Take home message:

Pediatric ME and exudates impose a special challenge in management. Therapy should be directed to the peripheral retinal pathology.