Intravitreal Anti–vascular Endothelial Growth Factor Therapy for Choroidal Neovascularization Secondary to Ocular Histoplasmosis Syndrome

Nielsen, Jared S.; Fick, Tyler A.; Saggau, David D.; Barnes, Charles D.

doi:10.1097/iae.0b013e318229b220

Cited by 25 publications

(10 citation statements)

References 14 publications

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“…Treatment of CNV is often successful with administration of anti-VEGF agents. [18,19] Our findings are consistent with these management patterns, with most of the anti-VEGF agent use occurring in the CNV group. PDT and corticosteroid use were also observed although with lower frequency compared with anti-VEGF therapy.…”

Section: Plos Onesupporting

confidence: 85%

Presumed ocular histoplasmosis syndrome in a commercially insured population, United States

et al. 2020

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To describe epidemiologic features of patients with presumed ocular histoplasmosis syndrome (POHS) in the United States using insurance claims data and compare POHS patients with and without choroidal neovascularization (CNV). Design Retrospective cohort study. Methods Patients with International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for histoplasmosis retinitis on an outpatient claim in the 2014 IBM ® Market-Scan ® Commercial Database and the Medicare Supplemental Database who were enrolled for at least 2 years after the POHS code. Main outcome measures Data related to testing, treatment, and direct medical costs. Results Among >50 million total MarketScan enrollees, 6,678 (13 per 100,000) had a POHS diagnosis code. Of those, 2,718 were enrolled for 2 years; 698 (25%) of whom had a CNV code. Eleven of the 13 states with the highest POHS rates bordered the Mississippi and Ohio rivers. CNV patients had significantly more eye care provider visits (mean 8.8 vs. 3.2, p<0.0001), more ophthalmic imaging tests, higher rates of treatment with anti-vascular endothelial growth factor injections (45% vs. 4%, p<0.0001), and incurred higher mean total yearly costs ($1,251.83 vs. $251.36, p<0.0001) than POHS patients without CNV.

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Section: Plos Onesupporting

confidence: 85%

Presumed ocular histoplasmosis syndrome in a commercially insured population, United States

et al. 2020

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“…None of the studies mentioned reported serious side effects related to treatment. 12,13,14 In our case, CNV regressed after a total of 5 doses of intravitreal ranibizumab, leaving a subretinal scar.…”

Section: Discussionmentioning

confidence: 52%

“…4 Case reports and case series support the efficacy of anti-VEGF agents in the treatment of CNV secondary to POHS. 4,12,13,14 …”

Section: Discussionmentioning

confidence: 99%

“…12 Nielsen et al 13 stated that anti-VEGF agents were beneficial in the treatment of CNV related to ocular histoplasmosis syndrome and found that these patients required an average of 4.5 intravitreal injections per year. Recently, Ramaiya et al 14 compared the efficacy and safety of PDT and intravitreal ranibizumab in the treatment of POHS-associated CNV and found that all patients in the PDT group required rescue ranibizumab injections and that the mean injection number was 7.7 in the ranibizumab group and 2.5 in the PDT group.…”

Section: Discussionmentioning

confidence: 99%

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Multiple Intravitreal Ranibizumab Injections for Persistant Choroidal Neovascularization Associated with Presumed Ocular Histoplasmosis Syndrome

Yılmaz

Dikçi

Genç

et al. 2017

tjo

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Presumed ocular histoplasmosis syndrome (POHS) is a clinical entity that is characterized by small, round, discrete, macular or mid peripheral atrophic (punched out) chorioretinal lesions (histo spots), peripapillary scarring, choroidal neovascularization (CNV), and the absence of anterior uveitis and vitritis. Diagnosis of this disorder is based upon characteristic clinical findings and a positive histoplasmin skin test or residence in an endemic region for Histoplasma capsulatum. There is no active systemic disease during diagnosis of POHS. Disciform scarring and macular CNV secondary to POHS is a well-known complication which leads to loss of visual acuity or visual disturbance. Without therapy, the visual prognosis in these patients is unfavorable. Submacular surgery, radiation, steroids, photodynamic therapy, and most recently anti-vascular endothelial growth factor therapy are current therapeutic options for this condition. We report a case with persistent CNV secondary to POHS in a middle-aged woman with moderate myopia and the clinical course of treatment with multiple intravitreal ranibizumab (Lucentis®, Novartis) injections.

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“…Schadlu et al [35] reported that 85% of 28 eyes had stabilized or improvement in vision with intravitreal bevacizumab therapy with approximately 43% eyes gaining three or more lines of vision. It demonstrated that 94% eyes had improved (81%) or stabilized (13%) visual acuity [36]. It demonstrated that 94% eyes had improved (81%) or stabilized (13%) visual acuity [36].…”

Section: Macular Photocoagulation and Submacular Surgerymentioning

confidence: 96%

Presumed ocular histoplasmosis

Thuruthumaly

Yee

Rao

2014

Current Opinion in Ophthalmology

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This review highlights the devastating vision loss that may occur in ocular histoplasmosis from the development of an atrophic scar at the fovea or following choroidal neovascularization. Many therapies have been tried with varied amounts of success. Antivascular endothelial growth factor therapy appears to be the gold-standard treatment with the possibility of combined photodynamic therapy in refractory cases.

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Intravitreal Anti–vascular Endothelial Growth Factor Therapy for Choroidal Neovascularization Secondary to Ocular Histoplasmosis Syndrome

Abstract: Long-term intravitreal anti-VEGF therapy with bevacizumab or ranibizumab is beneficial in treatment of choroidal neovascularization in ocular histoplasmosis syndrome.

Cited by 25 publications

References 14 publications

Presumed ocular histoplasmosis syndrome in a commercially insured population, United States

Presumed ocular histoplasmosis syndrome in a commercially insured population, United States

Multiple Intravitreal Ranibizumab Injections for Persistant Choroidal Neovascularization Associated with Presumed Ocular Histoplasmosis Syndrome

Presumed ocular histoplasmosis

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