Intravitreal anti-vascular endothelial growth factor for choroidal neovascularization in ocular histoplasmosis
PURPOSE: 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.