PERFUSION OF THE SUBFOVEAL CHORIOCAPILLARIS AFFECTS VISUAL RECOVERY AFTER SUBMACULAR SURGERY IN PRESUMED OCULAR HISTOPLASMOSIS SYNDROME

PURPOSE: To determine the relationship between the visual result and p erfusion of the subfoveal choriocapillaris after surgical excision of subfoveal neovascularization in presumed ocular histoplasmosis syndrom e. METHODS: We reviewed the records of 38 eyes of 37 patients with gra dable postoperative fluorescein angiograms and color photographs after surgical excision of a subfoveal neovascular membrane in presumed ocu lar histoplasmosis syndrome. The postoperative photographs and fluores cein angiograms were graded in a masked fashion for the presence of pe rfusion of the subfoveal choriocapillaris. We used preoperative and po stoperative best-corrected visual acuities to determine the correlatio n between postoperative perfusion of the subfoveal choriocapillaris an d both final visual acuity and visual improvement after surgery. RESUL TS: After surgery, the subfoveal choriocapillaris was perfused in 24 o f the 38 eyes (63%) and nonperfused in 14 (37%). Best-corrected visual acuity improved by at least 2 Snellin lines in 17 of the 24 perfused eyes (71%) and two of the 14 nonperfused eyes (14%) (P = .0089). Best- corrected visual acuity of 20/100 or better was achieved in 18 of the perfused eyes (75%) and four nonperfused eyes (29%) (P = .0076). CONCL USION: Both final visual acuity and improvement in visual acuity were correlated with postoperative perfusion of the subfoveal choriocapilla ris in patients with presumed ocular histoplasmosis syndrome. Developm ent of techniques to maintain or reestablish perfusion of the subfovea l choriocapillaris after surgery may improve visual outcome in these e yes.