Intravitreal Bevacizumab for the Treatment of Choroidal Neovascularization in Patients with Presumed Ocular Histoplasmosis Syndrome

Abstract

Purpose: : To report the effects of intravitreal bevacizumab therapy for choroidal neovascular membranes (CNVM) in patients with presumed ocular histoplasmosis syndrome (POHS).

Methods: : Retrospective review of consecutive case series. All patients diagnosed with CNVM associated with POHS and treated with intravitreal bevacizumab (1.25 mg) between December 2005 and November 2007 were included. Evaluation included visual acuity (VA), fluorescein angiography and/or optical coherence tomography (OCT). Institutional review board approval was obtained.

Results: : Fifteen eyes of 13 patients received intravitreal bevacizumab. Thirteen eyes had clinical and/or angiographic evidence of a subfoveal CNVM; the remaining two lesions were categorized as extrafoveal and peripapillary. Twelve of 13 eyes with subfoveal CNVM exhibited improved VA on the first post-treatment visit. At final examination, no patient demonstrated further loss of vision. Nine of 13 eyes (67% with baseline VA 20/60 or worse) demonstrated improved VA. Sixty-seven percent improved to 20/30 or better and 89% improved to 20/40 or better. Resolution was confirmed by fluorescein angiography and/or OCT. Eight of 13 eyes required a single intravitreal bevacizumab injection, whereas 1 eye required more than 3 treatments. There were no adverse effects to therapy.

Conclusions: : Our results demonstrated an improvement or stabilization of vision in all eyes receiving intravitreal bevacizumab for CNVM associated with POHS. These findings suggest intravitreal bevacizumab may be a successful therapeutic modality for the management of CNVM in patients with POHS.

Keywords: choroid: neovascularization