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M. G. Guess, R. S. Bucher, R. S. Moorthy; Intravitreal Bevacizumab for the Treatment of Choroidal Neovascularization in Ocular Histoplasmosis Syndrome. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1872.
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To evaluate the change in visual acuity, optical coherence tomographic parameters and and fluorescein angiographic characteristics in patients with macular choroidal neovascularization due to ocular histoplasmosis syndrome after primary treatment with intravitreal bevacizumab.
Retrospective consecutive, interventional case series. Patients with ocular histoplasmosis syndrome with new onset of subfoveal, juxtafoveal or extrafoveal choroidal neovascularization who received intravitreal bevacizumab as primary therapy were evaluated. Patients received an intravitreal dose of 1.25 mg (0.05 ml) of bevacizumab injection. Changes in visual acuity, clinical appearance, changes in central macular thickness as measured by optical coherence tomography (OCT) and fluorescein angiographic characteristics were evaluated.
Nine eyes of eight consecutive patients with extrafoveal, juxtafoveal and subfoveal choroidal neovascularization treated with intravitreal bevacizumab alone were reviewed retrospectively. The patients had no other underlying ocular conditions affecting visual acuity. Mean baseline visual acuity was 0.28 LogMAR, mean follow-up period was 15 months, and the number of intravitreal bevacizumab injections range from one to eight per eye. The mean visual acuity at last follow-up was 0.1 LogMAR, mean central macular thickness at baseline was 283 microns and improved to a mean of 219 microns at last follow-up. The surface area of the choroidal neovascularization on fluorescein angiography significantly decreased in size from a mean of 1.21 mm2 prior to treatment to 0.71 mm2 at final follow-up.
Patients experienced stable or improved visual acuity and dramatically improved clinical fundus appearance and fluorescein angiographic appearance without the development of paracentral scotomas. These findings suggest that intravitreal bevacizumab therapy is effective in the initial treatment of extrafoveal, juxtafoveal and subfoveal choroidal neovascularization associated with ocular histoplasmosis syndrome (OHS).
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