Subfoveal neovascularization in the ocular histoplasmosis syndrome. A natural history study.
The visual outcome of 74 eyes with the ocular histoplasmosis syndrome and active subfoveal subretinal neovascular membranes was studied retrospectively. Follow-up time ranged from 12 to 109 months (median, 36.5 months). Ten eyes (14%) retained visual acuity of 20/40 or better. Fifty-seven eyes (77%) suffered visual loss of 20/100 or worse and 36 eyes (49%) suffered visual loss of 20/400 or worse. Factors significantly associated with retaining vision of 20/40 or better were: age less than 30 years (P = 0.008); smaller membrane size (P = 0.0002); and absence of visual loss secondary to ocular histoplasmosis in the fellow eye (P = 0.053). Factors significantly associated with vision decreasing by four or more lines were: older patient age (P = 0.006); better initial visual acuity (P = 0.090); and more than 50% involvement of the foveal avascular zone (P = 0.059). These results were confirmed by multiple logistic regression. Final vision of 20/40 or better was associated with better initial visual acuity using univariate analysis, but this result was not confirmed by multiple logistic regression.
Kleiner
R C
RC
Wilmer Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205.
Ratner
C M
CM
Enger
C
C
Fine
S L
SL
D000328:Adult; D000367:Age Factors; D000368:Aged; D002829:Choroid / Q000473:pathology*; D005128:Eye Diseases / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D005584:Fovea Centralis; D006660:Histoplasmosis / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000209:etiology* / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D014792:Visual Acuity