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—It may be unjustified to change a triad of signs to a tetrad of signs if the additional sign occurs only in 5% of the cases. However, among our patients with histoplasmosis, the streaks were distinctive in location and orientation and were a relatively common finding. We do not know of any other defined syndrome in which these particular streaks have been seen repeatedly as they have in POHS. The same factors (unknown) that cause streaking in the POHS may be operative and cause occasional streaking in multifocal choroiditis of other presumed causes.Typical streaks may be seen occasionally in eyes without the other findings of ocular histoplasmosis. These cases may represent atypical cases of POHS, and, in endemic areas, this diagnosis should be seriously entertained. Obviously, in nonendemic areas and in cases in which accompanying findings are not compatible with POHS, alternate diagnoses must be sought. We
Fountain JA. Linear Equatorial Streaks-Reply. Arch Ophthalmol. 1981;99(8):1469. doi:10.1001/archopht.1981.03930020343031