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November 1997

Acute Histoplasmosis Choroiditis in 2 Immunocompetent Brothers

Author Affiliations

Iowa City, Iowa

Arch Ophthalmol. 1997;115(11):1470-1472. doi:10.1001/archopht.1997.01100160640023

Ocular infection with the fungus Histoplasma capsulatum may manifest in 2 ways. The first is an acute granulomatous uveitis or panophthalmitis that occurs in immunocompromised hosts. The second manifestation of ocular involvement by H capsulatum, seen in immunocompetent hosts, is the presumed ocular histoplasmosis syndrome (POHS). The syndrome is defined by peripheral atrophic scars, peripapillary atrophy, and choroidal neovascularization in the posterior pole (the "histoplasmosis triad"). It is still debated whether H capsulatum organisms have ever been definitively identified within these scars,1 and decades may elapse between the initial infection and the development of choroidal neovascularization.2 In addition, choroidal scars similar to those associated with POHS may be observed in other disorders. Although substantial epidemiological evidence exists that that there is a causal relationship between POHS and H capsulatum,3 the etiology of POHS remains unproven.

Acute choroidal infection in immunocompetent patients rarely, if ever, comes to the

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