INTRAVITREAL ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR FOR THE TREATMENT OF CHOROIDAL NEOVASCULARIZATION SECONDARY TO OCULAR HISTOPLASMOSIS: Ten-Year Follow-Up.

Abstract

PURPOSE:

To assess the long-term efficacy of intravitreal antivascular endothelial growth factor injections (IVI), alone or in combination with verteporfin photodynamic therapy (IVI/PDT), for management of choroidal neovascularization secondary to presumed ocular histoplasmosis syndrome (POHS).

METHODS:

Retrospective, comparative, interventional case series analyzing 82 eyes in 74 patients treated with either IVI or IVI/PDT for presumed ocular histoplasmosis syndrome choroidal neovascularization from January 2006 to January 2021.

RESULTS:

The average logarithm of the minimum angle of resolution VA in year 5 was 0.40 (20/50) and 0.52 (20/67) for IVI versus IVI/PDT groups, respectively ( P = 0.33), and in year 10 was 0.53 (20/58) and 0.64 (20/86), respectively ( P = 0.50). The average number of annual injections over the first 5 years of follow-up was 3.3 versus 1.7 for IVI versus IVI/PDT groups, respectively ( P < 0.001), and over 10 years was 3.3 versus 1.6, respectively ( P < 0.001). Treatment-free interval of 5 years was reached by 39% versus 60% in IVI versus IVI/PDT groups, respectively ( P = 0.95).

CONCLUSION:

Our study found both IVI and IVI/PDT to be effective in long-term management of presumed ocular histoplasmosis syndrome choroidal neovascularization, with a fewer number of annual injections and longer treatment-free interval in the combination group. However, given the limitations of a retrospective study, a prospective randomized study is necessary to determine whether the addition of PDT significantly decreases treatment burden.

• Authors: Nicholas E Dudenhoefer, Carl W Noble, Michael R Petersen, Robert E Foster, Christopher D Riemann, Robert A Sisk, Robert K Hutchins, Daniel M Miller
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 42 Issue 8 Pg. 1568-1573 (08 01 2022) ISSN: 1539-2864 [Electronic] United States
• PMID: 35877968 (Publication Type: Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized
• Endothelial Growth Factors
• Photosensitizing Agents
• Vascular Endothelial Growth Factor A

Topics

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Choroidal Neovascularization (diagnosis, drug therapy, etiology)
• Endothelial Growth Factors
• Eye Infections, Fungal (complications, drug therapy)
• Follow-Up Studies
• Histoplasmosis (complications, diagnosis, drug therapy)
• Humans
• Photochemotherapy
• Photosensitizing Agents (therapeutic use)
• Prospective Studies
• Retrospective Studies
• Treatment Outcome
• Vascular Endothelial Growth Factor A
• Visual Acuity