Intravitreal anti-vascular endothelial growth factor for choroidal neovascularization in ocular histoplasmosis.
OBJECTIVE
To report eight cases of long-term successful treatment of choroidal neovascularization because of ocular histoplasmosis syndrome with intravitreal anti-vascular endothelial growth factor agents.


METHODS
Retrospective case series. This article reviewed the course of eight eyes in seven patients who underwent intravitreal injection of bevacizumab and/or ranibizumab for treatment of choroidal neovascularization secondary to ocular histoplasmosis syndrome. Outcomes were assessed using pre- and post-anti-vascular endothelial growth factor visual acuities.


RESULTS
Eight eyes in seven patients were found to have new ocular histoplasmosis syndrome-associated subfoveal choroidal neovascularization lesions, as evidenced on clinical examination, fluorescein angiography, and optical coherence tomography. Intravitreal anti-vascular endothelial growth factor injections were used as initial or early treatment with successful resolution of the choroidal neovascularization lesions in most cases. Mean visual acuity improved from 20/60 to 20/47 over an average of 121.4 weeks. Either bevacizumab or ranibizumab was administered with an average of 2.6 injections per year of follow-up. Three eyes (37.5%) experienced a gain in visual acuity with a mean increase of 7.7 lines, 1 eye (12.5%) experienced no change, and 2 eyes (25%) experienced a loss of visual acuity of 2 or more lines. Six eyes (75%) were able to avoid mild visual loss (2 lines or less).


CONCLUSIONS
Intravitreal anti-vascular endothelial growth factor agents may successfully treat or at least stabilize neovascular complications of ocular histoplasmosis syndrome when used as a first-line treatment.
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois.
Jennifer
J
Hu
Quan V
QV
Hoang
Felix Y
FY
Chau
Michael P
MP
Blair
Jennifer I
JI
Lim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D015821:Eye Infections, Fungal / Q000150:complications*; D005260:Female; D006660:Histoplasmosis / Q000150:complications*; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab