July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Evaluation of the imaging features of Presumed Ocular Histoplasmosis Syndrome using Optical Coherence Tomography Angiography
Author Affiliations & Notes
  • Jack Li
    Ophthalmology, The Ohio State University - Havener Eye Institute, Columbus, Ohio, United States
  • Frederick Davidorf
    Ophthalmology, The Ohio State University - Havener Eye Institute, Columbus, Ohio, United States
  • Footnotes
    Commercial Relationships   Jack Li, None; Frederick Davidorf, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4539. doi:
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      Jack Li, Frederick Davidorf; Evaluation of the imaging features of Presumed Ocular Histoplasmosis Syndrome using Optical Coherence Tomography Angiography. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4539.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the specific OCTA macular imaging characteristics associated with POHS in a large set of patients and eyes. To identify early features associated with choroidal neovascularization (CNV) in POHS patients.

Methods : In a retrospective chart review, we investigate the OCTA results of patients with POHS who were observed at The Ohio State University (OSU) in Columbus, Ohio. The study has been approved by the institutional review board (IRB) of The Ohio State University. An ICD9/ICD10 review was conducted on patients who were seen at OSU between 01/01/2016 to 10/15/2018 who carried the diagnosis of POHS. Retrospective record review was then conducted to identify individuals who carry both the diagnosis of POHS and have been imaged by AngioPlex OCTA (Zeiss). Relevant information, including demographics, past ocular history, and disease history were collected. OCTA images were analyzed by experienced retina specialists and correlated with documented clinical course of patients.

Results : Seven patients and 14 eyes were identified and included in the study. The patients ranged from 36 to 79 years of age. Four patients were male (8 eyes) and three patients were female (6 eyes). All had bilateral POHS involvement. Six patients had neovascularization in at least one eye. One patient had neovascularization in both eyes. Best-corrected visual acuity (BCVA) in eyes without neovascularization was 0.51 + 0.37. BCVA in eyes without neovascularization was 0.40 + 0.41. In all cases, OCTA revealed sharply demarcated dropout in the choriocapillaris and deep choroid layer. OCTA imaging reveal enlargment of previous CNV on routine screening prior to symptomatic activation of CNV requiring treatment.

Conclusions : POHS is associated with specific imaging characteristics on OCTA imaging modality corresponding to the “Histo spots” noted on bio-microscopy. Characteristic signatures were identified on Angioplex (Zeiss) OCTA images, allowing for identification of active vs. inactive POHS lesions. Features can be identifed prior to development of symptoms of active POHS.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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