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M.H. Amaro, C. Muccioli, M. Abreu; Ocular Histoplasmosis–Like Syndrome from Nonendemic Area . Invest. Ophthalmol. Vis. Sci. 2006;47(13):299.
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To present 16 cases of Ocular Histoplasmosis–like Syndrome from a nonendemic area with negative antibody serology test to Histoplasmosis.
This is a Institutional , prospective study of 16 eyes from 8 immunocompetent patients who were evaluated between January 2001 and September 2005. There were six women and two men who were between 20 and 44 years old, (average 28 years.). All patients had clinical features that resembled the POHS.All patients had negative antibody serum test to Histoplasmosis. and negative medical and laboratorial evaluation to Toxoplasmosis, Syphilis and Tuberculosis. All patients underwent a complete ocular examination including fluorescein angiography. One patient also had been also submitted to indocyanine green angiography. Patients were treated when they presented with active choroidal neovascularization. We used diode laser photocoagulation or oral prednisone (1mg/kg/day) or intraocular injection of steroids (triamcinolone acetonide 4mg.)
Five patients presented with the classical triad of clinical features that include peripapillary scarring, histo spots, and choroidal neovascularization. One patient had an enlargement of an atrophic chorioretinal scar . One patient had multiple RPE detachments. One had a neovacularized RPE detachment and one had only histo spots.
Sixteen eyes from eight patients presented similar findings observed in ocular histoplasmosis syndrome . These patients had no signs of systemic or laboratorial histoplasmosis and others diseases that resembled ocular Histoplasmosis . We believe that the findings in the eyes of these patients were not due to Histoplasma capsulatum infection and that therefore other agents could cause a similar clinical picture as an atypical mycobacteria or the mycobacterium avium Intracellulare quoted in the literature.
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