title: New and classic insights into presumed ocular histoplasmosis syndrome and its treatment.
abstract: OBJECTIVE
  Presumed ocular histoplasmosis syndrome classically presents with atrophic choroidal scars, which are thought to progress into choroidal neovascularization in a small proportion of patients. The pathophysiology of the disease, including its underlying etiology, continues to be controversial and subject to ongoing research. Even more important is the controversy that surrounds the optimal treatment for choroidal neovascularization in patients with presumed ocular histoplasmosis, in particular that of subfoveal localization.
  
  
  BACKGROUND
  Intense efforts oriented toward defining the most beneficial therapeutic modality have resulted in some well-designed, large studies that evaluated submacular surgery, photodynamic therapies, and anti-angiogenic therapies, as well as small pilot studies exploring new therapeutic approaches for choroidal neovascularization.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, 46280, USA.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Oliver
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Ciulla
authors.forename: Grant M
authors.initials: GM
authors.lastname: Comer
mesh_terms: D020256:Choroidal Neovascularization / Q000209:etiology / Q000503:physiopathology; D015821:Eye Infections, Fungal / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D006660:Histoplasmosis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D013508:Ophthalmologic Surgical Procedures; D010778:Photochemotherapy; D013577:Syndrome