Intravitreal bevacizumab for choroidal neovascularization secondary to presumed ocular histoplasmosis syndrome

Purpose: The purpose of this study was to assess the efficacy of intravitreal bevacizumab for choroidal neovascularization resulting from presumed ocular histoplasmosis syndrome. Methods: This is a chart review of retrospective consecutive case series in which intravitreal bevacizumab (1.25 mg) was injected into 24 eyes with choroidal neovascularization resulting from presumed ocular histoplasmosis syndrome. Visual acuity was measured in all patients. Optical coherence tomography and/or fluorescein angiography was performed before and after treatment. The minimum follow-up time was 3 months. Retreatment criteria included failure to improve visual acuity and/or persistent leakage as determined by optical coherence tomography or fluorescein angiography. Results: Patients' mean age was 43.08 years (standard deviation, 13.58 years) and mean follow-up was 31.8 weeks (standard deviation, 20.79 weeks). The average number of bevacizumab injections was 6.8 injections/year. After 3 months, visual acuity improved from mean logMAR 0.76 ± 0.48 (Snellen equivalent of 20/114) to mean logMAR 0.45 ± 0.47 (Snellen equivalent of 20/55) (P < 0.001, paired t test; n = 24). After 12 months, visual acuity improved from mean logMAR 0.86 ± 0.35 (Snellen equivalent of 20/150) to mean logMAR 0.34 ± 0.33 (Snellen equivalent of 20/45) (P = 0.006, paired t test; n = 9). Fourteen (58.3%) eyes had final visual acuity of 20/40 or better compared with 5 (20.8%) eyes at baseline (P = 0.003, McNemar test). Ten patients (41.6%) had visual acuity of 20/200 or worse at baseline compared with 5 (20.8%) eyes at the final visit (P = 0.059, McNemar test). Conclusion: Intravitreal injection of bevacizumab seems to be an effective treatment for choroidal neovascularization resulting from presumed ocular histoplasmosis syndrome.