Recurrence of Choroidal Neovascularization in Ocular Histoplasmosis 50 Years After Photocoagulation

Purpose: To report a case of recurrence of choroidal neovascularization (CNV) in a patient with presumed ocular histoplasmosis syndrome (POHS), 50 years after initial macular photocoagulation treatment. Methods: A 79-year-old female with a history of presumed ocular histoplasmosis presented 50 years after successful laser photocoagulation with recurrence of symptoms and was treated with intravitreal anti-VEGF therapy. Results: Following a series of intravitreal anti-VEGF treatments, careful monitoring of OCT demonstrated near complete resolution of macular edema after 10 months. The patient remained dry without anti-VEGF therapy for over a year since presentation. Conclusion: This case highlights the recurrence of CNV in POHS 50 years after initial photocoagulation therapy. It demonstrates the importance of continued monitoring in patients with POHS, even many years after successful macular photocoagulation, as late recurrences can respond effectively to anti-VEGF therapy.