Intravitreal bevacizumab for choroidal neovascularization secondary to presumed ocular histoplasmosis syndrome.
OBJECTIVE
The purpose of this study was to assess the efficacy of intravitreal bevacizumab for choroidal neovascularization resulting from presumed ocular histoplasmosis syndrome.


METHODS
This is a chart review of retrospective consecutive case series in which intravitreal bevacizumab (1.25 mg) was injected into 24 eyes with choroidal neovascularization resulting from presumed ocular histoplasmosis syndrome. Visual acuity was measured in all patients. Optical coherence tomography and/or fluorescein angiography was performed before and after treatment. The minimum follow-up time was 3 months. Retreatment criteria included failure to improve visual acuity and/or persistent leakage as determined by optical coherence tomography or fluorescein angiography.


RESULTS
Patients' mean age was 43.08 years (standard deviation, 13.58 years) and mean follow-up was 31.8 weeks (standard deviation, 20.79 weeks). The average number of bevacizumab injections was 6.8 injections/year. After 3 months, visual acuity improved from mean logMAR 0.76 +/- 0.48 (Snellen equivalent of 20/114) to mean logMAR 0.45 +/- 0.47 (Snellen equivalent of 20/55) (P < 0.001, paired t test; n = 24). After 12 months, visual acuity improved from mean logMAR 0.86 +/- 0.35 (Snellen equivalent of 20/150) to mean logMAR 0.34 +/- 0.33 (Snellen equivalent of 20/45) (P = 0.006, paired t test; n = 9). Fourteen (58.3%) eyes had final visual acuity of 20/40 or better compared with 5 (20.8%) eyes at baseline (P = 0.003, McNemar test). Ten patients (41.6%) had visual acuity of 20/200 or worse at baseline compared with 5 (20.8%) eyes at the final visit (P = 0.059, McNemar test).


CONCLUSIONS
Intravitreal injection of bevacizumab seems to be an effective treatment for choroidal neovascularization resulting from presumed ocular histoplasmosis syndrome.
Ehrlich
Rita
R
Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN 46202, USA. ehrlichy@netvision.net.il
Ciulla
Thomas A
TA
Maturi
Raj
R
Kheradiya
Nisha S
NS
Hrisomalos
Nick
N
Shulman
Shiri
S
Guess
Matthew G
MG
Coyle
Ellen
E
Harris
Alon
A
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D015821:Eye Infections, Fungal / Q000150:complications*; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006660:Histoplasmosis / Q000150:complications*; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D012189:Retrospective Studies; D013577:Syndrome; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab