Purchase this article with an account.
Sarah Escott, Susie Chang, Ahmad Tarabishy, Mark Barsamian, John Christoforidis, Frederick Davidorf, Alan Letson; Long-term results of Intravitreal Bevacizumab for the Treatment of Choroidal Neovascular Membranes associated with Presumed Ocular Histoplasmosis Syndrome. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2935.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To assess the long-term efficacy of intravitreal bevacizumab therapy for choroidal neovascularization (CNV) in patients with presumed ocular histoplasmosis syndrome (POHS).
All patients diagnosed with CNV associated with POHS and treated with intravitreal bevacizumab (1.25 mg) between December 2005 and September 2012 were included. Baseline best-corrected visual acuity (BCVA) was compared with first post-treatment visit BCVA and final visit BCVA. Fluorescein angiography confirmed the presence of CNV prior to initial treatment.
Seventeen eyes of 12 patients received intravitreal bevacizumab. Nine eyes were newly diagnosed; the remaining 8 previously treated eyes received prior therapy for CNV more than 1 year before initiation of intravitreal bevacizumab treatment. Mean follow-up was 45.24 months (3.77 years) with a range of 2.4 to 6.4 years. Overall there was a statistically significant improvement in mean logMAR VA after 1 treatment (0.16, Snellen equivalent of 20/29) when compared to mean baseline logMAR VA (0.35, Snellen equivalent of 20/45). At final visit, treatment effect was sustained in 15 of 17 study eyes. The improvement between baseline and final BCVA outcome in both the treatment naive and previously treated groups were not statistically significant; however the overall improvement in vision was greater in those naive to treatment (-0.16 versus -0.04 log MAR improvement). Eyes with subfoveal lesions (n=13) as a group demonstrated a statistically significant improvement of BCVA from baseline to both first post-treatment visit and final visit.
Long-term visual outcomes are favorable for patients treated with intravitreal bevacizumab for CNV associated with POHS. In patients with POHS, intravitreal bevacizumab may be more effective as initial therapy for new onset CNV and without other previous treatment. Furthermore, we demonstrate that in the majority of treatment naive eyes, the visual acuity is sustained over a period of at least four years. These findings suggest intravitreal bevacizumab is an appropriate first-line therapy for the management of CNV in patients with POHS.
This PDF is available to Subscribers Only