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December 1984, Vol 102, No. 12 >
ARTICLE | December 1984

Epidemiology of Presumed Ocular Histoplasmosis FREE

James P. Ganley, MD, DPH
Arch Ophthalmol. 1984;102(12):1754-1756. doi:10.1001/archopht.1984.01040031418014
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Dreyer and Gass1 have expanded clinical and epidemiologic characteristics of a uveitis syndrome, initially described in 1973 by Nozik and Dorsch,2 that is characterized by punched-out chorioretinal lesions, submacular choroidal neovascular net, disciform lesion, vitritis, and anterior segment inflammation. Although this disease in many ways mimics presumed ocular histoplasmosis, the clinical and epidemiologic characteristics clearly differentiate the two disorders. The features differentiating this uveitis syndrome from acute multifocal placoid pigment epitheliopathy (AMPPE), diffuse unilateral subacute neuroretinitis (DUSN), and birdshot (vitiliginous) choroiditis are less clear.

See also p 1776.  Although all the aforementioned conditions (except DUSN) are characterized by small, circumscribed chorioretinal lesions and a disciform process, they are differentiated from presumed ocular histoplasmosis by the symptomatic onset of the chorioretinal lesions, their smaller size and more irregular configuration, presence of vitreous cells, and signs of anterior segment inflammation. Of the latter group of disorders, only DUSN has

REFERENCES

1 +
Dreyer RF, Gass JDM:  Multifocal choroiditis and panuveitis: A syndrome that mimics ocular histoplasmosis . Arch Ophthalmol 1984;;102:1776-1784.
2 +
Nozik RA, Dorsch W:  A new chorioretinopathy associated with anterior uveitis . Am J Ophthalmol 1973;;76:758-762.
3 +
Kazacos KR, Vestre WA, Kazacos EA, et al:  Diffuse unilateral subacute neuroretinitis syndrome: Probable cause . Arch Ophthalmol 1984;;102:967-968.
4 +
Krause AC, Hopkins WG:  Ocular manifestation of histoplasmosis . Am J Ophthalmol 1951;;34:564-566.
5 +
Woods AC, Wahlen HE:  The probable role of benign histoplasmosis in the etiology of granulomatous uveitis . Trans Am Ophthalmol Soc 1959;;57:318-343.
6 +
Walma D, Schlaegel TF:  Presumed histoplasmic choroiditis: A clinical analysis of 43 cases . Am J Ophthalmol 1964;;57:107-110.
7 +
Asbury T:  The status of presumed ocular histoplasmosis including a report of a survey . Trans Am Ophthalmol Soc 1966;; 64:371-400.
8 +
Spaeth GL:  Absence of so-called histoplasma uveitis in 134 cases of proven histoplasmosis . Arch Ophthalmol 1967;;77:41-44.
9 +
Schlaegel TF, Weber JC, Helveston E, et al:  Presumed histoplasmic choroiditis . Am J Ophthalmol 1967;;63:919-925.
10 +
Smith RE, Ganley JP:  An epidemiologic study of presumed ocular histoplasmosis . Trans Am Acad Ophthalmol Otolaryngol 1971;;75:994-1005.
11 +
Ganley JP, Smith RE, Knox DL, et al:  Presumed ocular histoplasmosis: III. Epidemiologic characteristics of people with peripheral atrophic scars . Arch Ophthalmol 1973;;89:116-119.
12 +
Ganley JP:  Epidemiologic characteristics of presumed ocular histoplasmosis . Acta Ophthalmol 1973;;119( (suppl) ):1-63.
13 +
Davidorf FH, Anderson JD:  Ocular lesions in the Earth Day histoplasmosis epidemic . Trans Am Acad Ophthalmol Otolaryngol 1974;;78:876-881.
14 +
Check IJ, Diddie KR, Jay WM, et al:  Lymphocyte stimulation by yeast phase Histoplasma capsulatum in presumed ocular histoplasmosis syndrome . Am J Ophthalmol 1979;;87:311-316.
15 +
Ganley JP, Nemo GJ, Comstock GW, et al:  Lymphocyte transformation in presumed ocular histoplasmosis . Arch Ophthalmol 1981;;99:1424-1429.
16 +
Ellis FD, Schlaegel TF:  The geographic localization of presumed histoplasmic choroiditis . Am J Ophthalmol 1973;;75:953-956.
17 +
Maumenee AE:  Clinical entities in `uveitis': An approach to the study of intraocular inflammation . Am J Ophthalmol 1970;; 69:1-27.
18 +
Roth AM:  Histoplasma capsulatum in the presumed ocular histoplasmosis syndrome . Am J Ophthalmol 1977;;84:293-298.
19 +
Kahill MK:  Histopathology of presumed ocular histoplasmosis . Am J Ophthalmol 1982;;94:369-376.
20 +
Meredith TA, Green WR, Key SN, et al:  Ocular histoplasmosis: Clinicopathologic correlation of three cases . Surv Ophthalmol 1977;;22:189-205.
21 +
Wong VG:  Focal choroidopathy in experimental ocular histoplasmosis . Trans Am Ophthalmol Soc 1972;;70:615-630.
22 +
Smith RE, Macy JI, Parrett C, et al:  Variations in acute multifocal histoplasmic choroiditis in the primate . Invest Ophthalmol Vis Sci 1978;;17:1005-1018.
23 +
Van Metre TE, Maumenee AE:  Specific ocular uveal lesions in patients with evidence of histoplasmosis . Arch Ophthalmol 1964;;71:314-324.
24 +
Suie T, Rheins MS, Makley TA:  Serologic studies of presumed histoplasmic choroiditis . Am J Ophthalmol 1965;;60:1059-1061.
25 +
Flage T, Sand B, Syrdalen P:  Hemorrhagic maculopathy in young adults . Acta Ophthalmol 1977;;55:489-496.
26 +
Saari M:  Disciform detachment of the macula: I. Juvenile haemorrhagic macular choroidopathy . Acta Ophthalmol 1977;; 55:525-529.

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1 +
Dreyer RF, Gass JDM:  Multifocal choroiditis and panuveitis: A syndrome that mimics ocular histoplasmosis . Arch Ophthalmol 1984;;102:1776-1784.
2 +
Nozik RA, Dorsch W:  A new chorioretinopathy associated with anterior uveitis . Am J Ophthalmol 1973;;76:758-762.
3 +
Kazacos KR, Vestre WA, Kazacos EA, et al:  Diffuse unilateral subacute neuroretinitis syndrome: Probable cause . Arch Ophthalmol 1984;;102:967-968.
4 +
Krause AC, Hopkins WG:  Ocular manifestation of histoplasmosis . Am J Ophthalmol 1951;;34:564-566.
5 +
Woods AC, Wahlen HE:  The probable role of benign histoplasmosis in the etiology of granulomatous uveitis . Trans Am Ophthalmol Soc 1959;;57:318-343.
6 +
Walma D, Schlaegel TF:  Presumed histoplasmic choroiditis: A clinical analysis of 43 cases . Am J Ophthalmol 1964;;57:107-110.
7 +
Asbury T:  The status of presumed ocular histoplasmosis including a report of a survey . Trans Am Ophthalmol Soc 1966;; 64:371-400.
8 +
Spaeth GL:  Absence of so-called histoplasma uveitis in 134 cases of proven histoplasmosis . Arch Ophthalmol 1967;;77:41-44.
9 +
Schlaegel TF, Weber JC, Helveston E, et al:  Presumed histoplasmic choroiditis . Am J Ophthalmol 1967;;63:919-925.
10 +
Smith RE, Ganley JP:  An epidemiologic study of presumed ocular histoplasmosis . Trans Am Acad Ophthalmol Otolaryngol 1971;;75:994-1005.
11 +
Ganley JP, Smith RE, Knox DL, et al:  Presumed ocular histoplasmosis: III. Epidemiologic characteristics of people with peripheral atrophic scars . Arch Ophthalmol 1973;;89:116-119.
12 +
Ganley JP:  Epidemiologic characteristics of presumed ocular histoplasmosis . Acta Ophthalmol 1973;;119( (suppl) ):1-63.
13 +
Davidorf FH, Anderson JD:  Ocular lesions in the Earth Day histoplasmosis epidemic . Trans Am Acad Ophthalmol Otolaryngol 1974;;78:876-881.
14 +
Check IJ, Diddie KR, Jay WM, et al:  Lymphocyte stimulation by yeast phase Histoplasma capsulatum in presumed ocular histoplasmosis syndrome . Am J Ophthalmol 1979;;87:311-316.
15 +
Ganley JP, Nemo GJ, Comstock GW, et al:  Lymphocyte transformation in presumed ocular histoplasmosis . Arch Ophthalmol 1981;;99:1424-1429.
16 +
Ellis FD, Schlaegel TF:  The geographic localization of presumed histoplasmic choroiditis . Am J Ophthalmol 1973;;75:953-956.
17 +
Maumenee AE:  Clinical entities in `uveitis': An approach to the study of intraocular inflammation . Am J Ophthalmol 1970;; 69:1-27.
18 +
Roth AM:  Histoplasma capsulatum in the presumed ocular histoplasmosis syndrome . Am J Ophthalmol 1977;;84:293-298.
19 +
Kahill MK:  Histopathology of presumed ocular histoplasmosis . Am J Ophthalmol 1982;;94:369-376.
20 +
Meredith TA, Green WR, Key SN, et al:  Ocular histoplasmosis: Clinicopathologic correlation of three cases . Surv Ophthalmol 1977;;22:189-205.
21 +
Wong VG:  Focal choroidopathy in experimental ocular histoplasmosis . Trans Am Ophthalmol Soc 1972;;70:615-630.
22 +
Smith RE, Macy JI, Parrett C, et al:  Variations in acute multifocal histoplasmic choroiditis in the primate . Invest Ophthalmol Vis Sci 1978;;17:1005-1018.
23 +
Van Metre TE, Maumenee AE:  Specific ocular uveal lesions in patients with evidence of histoplasmosis . Arch Ophthalmol 1964;;71:314-324.
24 +
Suie T, Rheins MS, Makley TA:  Serologic studies of presumed histoplasmic choroiditis . Am J Ophthalmol 1965;;60:1059-1061.
25 +
Flage T, Sand B, Syrdalen P:  Hemorrhagic maculopathy in young adults . Acta Ophthalmol 1977;;55:489-496.
26 +
Saari M:  Disciform detachment of the macula: I. Juvenile haemorrhagic macular choroidopathy . Acta Ophthalmol 1977;; 55:525-529.

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