New and classic insights into presumed ocular histoplasmosis syndrome and its treatment

Abstract

Important results obtained by these studies were recently made public, and the conclusions that may be drawn from them, as well as an update on findings concerning presumed ocular histoplasmosis etiology, epidemiology, and pathophysiology are presented in this report.

CNVM in POHS

“…One study examined the outcome of 14 patients who had this surgery performed, with the majority of the patients having CNVM extending into the fovea. This study determined that this surgery was successful because the majority of patients regained 20/40 vision or better after the surgery [10][11][12]. However, there were several downsides with this treatment.…”

“…Patients that completed this surgical removal were less likely to have recurrences of the net if they were younger patients and had not had prior laser treatment. Also, with this removal, if a net were to recur, it usually happened within the first five months after surgery; this recurrence happened in approximately 40% of the patients [10][11][12]. The surgical removal of a recurrent membrane did not show significant improvements in the patients, and other treatments had to be tried [10][11][12].…”

“…Another study came to similar conclusions. Sixty-three patients were evaluated after surgical removal of the CNVM, with approximately 18% of these patients achieving better than 20/50 vision, and 40% of patients having no change in visual acuity status [10][11][12]. Patients that completed this surgical removal were less likely to have recurrences of the net if they were younger patients and had not had prior laser treatment.…”

Eye Cancer Incidence in U.S. States and Access to Fluoridated Water

“…It is noteworthy that a type of multifocal choroiditis occurs in Oregon. Watzke and colleagues described 10 patients with choroiditis that was identical to presumed ocular histoplasmosis, a choroidal disease thought to result from systemic infection with the fungus, Histoplasma capsulatum, which is prevalent in the United States, Ohio and Mississippi river valleys (23,24). However, the Oregon patients were seronegative for Histoplasma and had not traveled to regions in which this fungus is endemic.…”

Acute systemic histoplasmosis associated with chorioretinitis in an immunocompetent adolescent

“…Choroidal neovascularization is the most common cause of vision loss and is estimated to occur in less than 5% of affected eyes. 5 Multifocal chorioretinitis is thought to occur in patients with sufficient immunologic capability to localize and respond to H. capsulatum infection. The chorioretinal lesions are generally small (<400 μm diameter) and appear oval and creamy white, with either distinct or fluffy borders.…”