massive peripapillary subretinal neovascularization: an indication for submacular surgery.
OBJECTIVE
To describe the course and outcome of three consecutive patients with massive peripapillary subretinal neovascularization secondary to ocular histoplasmosis syndrome managed with submacular surgery.


METHODS
Three eyes of three consecutive patients with progressive and massive peripapillary subretinal neovascularization secondary to ocular histoplasmosis syndrome were treated with submacular surgery and followed up for a mean of 41 months (range, 11-59 months). The main outcomes were surgical complications, visual acuity, and subretinal membrane recurrence.


RESULTS
Visual acuity improved in each patient from counting fingers, 20/25, and 20/400 preoperatively to 20/50, 20/20, and 20/20, respectively, at the last follow-up visit. With respect to complications, Patient 3 was found to have an operculated retinal tear approximately 1 month postoperatively, which was successfully treated with argon laser retinopexy. There were no cases of visually significant cataract, rhegmatogenous retinal detachment, or recurrent choroidal neovascularization in any of the operated eyes during the period of follow-up.


CONCLUSIONS
Submacular surgery proved safe and beneficial in this small series of young patients with massive peripapillary subretinal neovascularization secondary to ocular histoplasmosis syndrome and should be considered in this relatively uncommon clinical presentation.
Kertes
Peter J
PJ
University of Ottawa Eye Institute, The Ottawa Hospital, Ottawa, Ontario, Canada. peter.kertes@sw.ca
D000328:Adult; D015821:Eye Infections, Fungal / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006660:Histoplasmosis / Q000150:complications*; D006801:Humans; D008266:Macula Lutea / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014792:Visual Acuity