Managing recurrent neovascularization after subfoveal surgery in presumed ocular histoplasmosis syndrome

Purpose: To report the authors' experience with recurrent neovascularization after subfoveal surgery in the presumed ocular histoplasmosis syndrome (POHS). Methods: One-hundred seventeen patients with POHS and subfoveal choroidal neovascularization were followed a median of 13 months after submacular surgery. Results: Recurrent neovascularization developed in 51 eyes (44%). The median time to recurrence was 3 months (range, 0.5-28 months). Recurrence location was extrafoveal in 16%, juxtafoveal in 18%, and subfoveal in 66%. Sixteen eyes were treated with laser photocoagulation, 17 eyes underwent repeat submacular surgery, and 18 eyes were observed, The visual outcome for patients with recurrences amenable to laser was better than that for patients who were observed or who underwent surgery. Conclusion: Recurrent neovascularization after surgery is common; prompt recognition may allow laser photocoagulation.