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

Retin Cases Brief Rep. 2014 Winter;8(1):24-9. doi: 10.1097/ICB.0b013e3182a48bcc.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage*
  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Bevacizumab
  • Choroidal Neovascularization / drug therapy*
  • Eye Infections, Fungal / complications*
  • Female
  • Histoplasmosis / complications*
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Ranibizumab
  • Retrospective Studies
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Ranibizumab