Subfoveal neovascularization in the ocular histoplasmosis syndrome. A natural history study

• Published in: Retina (Philadelphia, Pa.) Vol. 8; no. 4; p. 225
• Main Authors: Kleiner, R C, Ratner, C M, Enger, C, Fine, S L
• Format: Journal Article
• Language: English
• Published: United States 1988
• Subjects: Adult; Age Factors; Aged; Choroid - pathology; Eye Diseases - complications; Female; Fluorescein Angiography; Fovea Centralis; Histoplasmosis - complications; Humans; Male; Middle Aged; Neovascularization, Pathologic - etiology; Neovascularization, Pathologic - pathology; Prognosis; Retrospective Studies; Visual Acuity
• ISSN: 0275-004X
• DOI: 10.1097/00006982-198808040-00001

The visual outcome of 74 eyes with the ocular histoplasmosis syndrome and active subfoveal subretinal neovascular membranes was studied retrospectively. Follow-up time ranged from 12 to 109 months (median, 36.5 months). Ten eyes (14%) retained visual acuity of 20/40 or better. Fifty-seven eyes (77%) suffered visual loss of 20/100 or worse and 36 eyes (49%) suffered visual loss of 20/400 or worse. Factors significantly associated with retaining vision of 20/40 or better were: age less than 30 years (P = 0.008); smaller membrane size (P = 0.0002); and absence of visual loss secondary to ocular histoplasmosis in the fellow eye (P = 0.053). Factors significantly associated with vision decreasing by four or more lines were: older patient age (P = 0.006); better initial visual acuity (P = 0.090); and more than 50% involvement of the foveal avascular zone (P = 0.059). These results were confirmed by multiple logistic regression. Final vision of 20/40 or better was associated with better initial visual acuity using univariate analysis, but this result was not confirmed by multiple logistic regression.