Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography

Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography

A 37-year-old Caucasian woman presented with acute decrease in central vision in her right eye and was found to have subfoveal choroidal neovascularization (CNV) due to presumed ocular histoplasmosis syndrome (POHS). Her visual acuity improved from 20/70 to 20/20 at her 6-month follow-up, after 3 co...

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Main Authors: T. Y. Alvin Liu, Alice Yang Zhang, Adam Wenick
Format: Article
Language:English
Published: Hindawi Limited 2018-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2018/4098419
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spelling doaj-0405f67ba95c45408a3f900d5bbe1a722020-11-25T00:55:06ZengHindawi LimitedCase Reports in Ophthalmological Medicine2090-67222090-67302018-01-01201810.1155/2018/40984194098419Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography AngiographyT. Y. Alvin Liu0Alice Yang Zhang1Adam Wenick2Retina Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USARetina Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USARetina Division, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USAA 37-year-old Caucasian woman presented with acute decrease in central vision in her right eye and was found to have subfoveal choroidal neovascularization (CNV) due to presumed ocular histoplasmosis syndrome (POHS). Her visual acuity improved from 20/70 to 20/20 at her 6-month follow-up, after 3 consecutive monthly intravitreal bevacizumab injections were initiated at her first visit. Although no CNV activity was seen on fluorescein angiography (FA) or spectral-domain optical coherence tomography (SD-OCT) at her 2-month, 4-month, and 6-month follow-up visits, persistent flow in the CNV lesion was detected on optical coherence tomography angiography (OCTA). OCTA shows persistent vascular flow as well as changes in vascular flow in CNV lesions associated with POHS, indicating the continued presence of patent vessels and changes in these CNV lesions, even when traditional imaging of the lesion with OCT and FA indicates stability of the lesion with no disease activity. Additional cases with longitudinal follow-up are needed to assess how OCTA should be incorporated into clinical practice.http://dx.doi.org/10.1155/2018/4098419
collection DOAJ
language English
format Article
sources DOAJ
author T. Y. Alvin Liu
Alice Yang Zhang
Adam Wenick
spellingShingle T. Y. Alvin Liu
Alice Yang Zhang
Adam Wenick
Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography
Case Reports in Ophthalmological Medicine
author_facet T. Y. Alvin Liu
Alice Yang Zhang
Adam Wenick
author_sort T. Y. Alvin Liu
title Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography
title_short Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography
title_full Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography
title_fullStr Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography
title_full_unstemmed Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography
title_sort evolution of choroidal neovascularization due to presumed ocular histoplasmosis syndrome on multimodal imaging including optical coherence tomography angiography
publisher Hindawi Limited
series Case Reports in Ophthalmological Medicine
issn 2090-6722
2090-6730
publishDate 2018-01-01
description A 37-year-old Caucasian woman presented with acute decrease in central vision in her right eye and was found to have subfoveal choroidal neovascularization (CNV) due to presumed ocular histoplasmosis syndrome (POHS). Her visual acuity improved from 20/70 to 20/20 at her 6-month follow-up, after 3 consecutive monthly intravitreal bevacizumab injections were initiated at her first visit. Although no CNV activity was seen on fluorescein angiography (FA) or spectral-domain optical coherence tomography (SD-OCT) at her 2-month, 4-month, and 6-month follow-up visits, persistent flow in the CNV lesion was detected on optical coherence tomography angiography (OCTA). OCTA shows persistent vascular flow as well as changes in vascular flow in CNV lesions associated with POHS, indicating the continued presence of patent vessels and changes in these CNV lesions, even when traditional imaging of the lesion with OCT and FA indicates stability of the lesion with no disease activity. Additional cases with longitudinal follow-up are needed to assess how OCTA should be incorporated into clinical practice.
url http://dx.doi.org/10.1155/2018/4098419
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AT aliceyangzhang evolutionofchoroidalneovascularizationduetopresumedocularhistoplasmosissyndromeonmultimodalimagingincludingopticalcoherencetomographyangiography
AT adamwenick evolutionofchoroidalneovascularizationduetopresumedocularhistoplasmosissyndromeonmultimodalimagingincludingopticalcoherencetomographyangiography
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