Avastin for presumed ocular histoplasmosis

[MyVisionTest]

Intravitreal Avastin (bevacizumab) is effective in the treatment of
choroidal neovascularization (CNV) resulting from presumed ocular
histoplasmosis syndrome, according to a new study.

Histoplasmosis is a disease caused when airborne spores of the fungus
Histoplasma capsulatum are inhaled in the lungs. Histoplasmosis is
sometimes so mild that it produces no apparent symptoms. However,
later it can lead to a serious eye disease called ocular
histoplasmosis syndrome, a leading cause of vision loss in middle-aged
persons. Scientists believe that Histoplasma capsulatum (histo) spores
spread from the lungs to the eye, where it can trigger CNV. Laser
photocoagulation is effective for CNV secondary to histoplasmosis.
Early studies suggest that Avastin and Lucentis is also an effective
treatment.

This study is a retrospective review of consecutive cases in which
intravitreal Avastin (1.25 mg) was injected into 24 eyes with CNV
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.

Patients' mean age was 43 years and mean follow-up was 31.8 weeks. The
average number of Avastin injections was 6.8 injections/year. After 3
months, visual acuity improved from mean logMAR 0.76 to mean logMAR
0.45 (P < 0.001). After 12 months, visual acuity improved from mean
logMAR 0.86 to mean logMAR 0.34 (P = 0.006). Fourteen (58.3%) eyes had
final visual acuity of 20/40 or better compared with 5 (20.8%) eyes at
baseline (P = 0.003). 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).

The investigators conclude that intravitreal Avastin seems to be an
effective treatment for choroidal neovascularization resulting from
presumed ocular histoplasmosis syndrome.

Retina. 2009 Nov-Dec;29(10):1418-23

http://www.ncbi.nlm.nih.gov/pubmed/19898179

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