Intravitreal bevacizumab as initial treatment for choroidal neovascularization associated with presumed ocular histoplasmosis syndrome

Abstract

This case report describes a case of juxtafoveal choroidal neovascularization associated with POHS that responded remarkably well to intravitreal injection of bevacizumab.

Intravitreal bevacizumab (Avastin) treatment of choroidal neovascularisation in patients with angioid streaks

“…Recent publications suggest expanded indications for intravitreal bevacizumab to include the management of CNV due to non-AMD aetiologies such as pathological myopia,8 idiopathic CNV9 and ocular histoplasmosis 10. To our knowledge, five reports have been published on the use of intravitreal bevacizumab for the treatment of CNV in patients with angioid streaks 11 – 15.…”

Antivascular Endothelial Growth Factors for Inflammatory Chorioretinal Disorders

“…Positive functional and anatomical outcomes have been described in a single case report, with VA improvement from 20/200 to 20/60 over a 1-year follow-up and a single intravitreal injection of bevacizumab [37].…”

CNVM in POHS

“…There have been multiple case review studies that have supported anti-VEGF agents being effectively used to treat the CNVM caused by POHS. Depending on the review, between 60-80% of patients developed an increase in central visual acuity with most of the patients ending up around 20/50 [10,[22][23][24]. Some benefits of the intravitreal injection are that there is no surgery involved, it is effective in treating a macular edema caused by CNVM, and is even effective in decreasing edema caused by diabetes.…”

“…The anti-VEGF agents block the formation of new neovascularization and work to help stabilize the blood-retinal barrier so that eventually the neovascular membrane will die off. An advantage of this particular treatment compared to the gold standard, the laser, is that the patient does not develop a scotoma as they do in the laser procedure [10,[22][23][24].…”