title: Ocular histoplasmosis syndrome.
abstract: Ocular histoplasmosis syndrome (OHS) is a chorioretinal disorder with a distinct fundus appearance that is commonly found in regions endemic for Histoplasma capsulatum. Choroidal neovascularization (CNV) secondary to OHS is considered one of the principal causes of central vision loss among young adults in endemic areas. Although there is no consensus regarding its pathogenesis, evidence points to Histoplasma capsulatum as the most probable etiology. Once considered an intractable hemorrhagic maculopathy, CNVs are now treatable. Extrafoveal CNVs are successfully treated with laser photocoagulation. Subfoveal and juxtafoveal CNVs are managed with anti-vascular endothelial growth factor therapy, photodynamic therapy, or a combination of both. Modern imaging technologies such as spectral-domain optical coherence tomography have improved our diagnostic abilities, making it easier to monitor disease activity and CNV regression. We review the epidemiology, pathogenesis, clinical manifestations, differential diagnosis, and current treatment of this disease.
authors.affiliation: Department of Vitreoretinal Surgery, Charles Retina Institute, Memphis, Tennessee, USA; Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA. Electronic address: rdiaz@charles-retina.com.
authors.forename: Rocio I
authors.initials: RI
authors.lastname: Diaz
authors.affiliation: Department of Vitreoretinal Surgery, Charles Retina Institute, Memphis, Tennessee, USA; Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA; Division of Retina and Vitreous, Ophthalmic Consultants of Long Island, Lynbrook, New York, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Sigler
authors.affiliation: Department of Vitreoretinal Surgery, Charles Retina Institute, Memphis, Tennessee, USA.
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Rafieetary
authors.affiliation: Department of Vitreoretinal Surgery, Charles Retina Institute, Memphis, Tennessee, USA; Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
authors.forename: Jorge I
authors.initials: JI
authors.lastname: Calzada
mesh_terms: D000818:Animals; D015862:Choroid Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D004195:Disease Models, Animal; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D006660:Histoplasmosis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D006801:Humans; D012164:Retinal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy
keywords: Histoplasma capsulatum; anti-VEGF; bevacizumab; histoplasmosis; ocular histoplasmosis syndrome; photocoagulation; photodynamic therapy; presumed ocular histoplasmosis syndrome; ranibizumab; submacular surgery