Case 9-6, Presumed Ocular Histoplasmosis Syndrome
A 45-year-old man with a history of presumed ocular histoplasmosis reported mild distortion and blurring in his left eye since his most recent laser treatment. His visual acuity was assessed at 20/60, Dilated fundus examination (A) revealed a dry laser scar inferior to fixation, multiple punched-out chorioretinal scars throughout the posterior pole, and very mild peripapillary atrophy. A thin sub retinal hemorrhage was noted in the central macula. A small depigmented area that appeared to be choroidal neovascularization was observed just superior to the fovea, Fluorescein angiography (B) showed a crescent of hvperil uorescence inferior to the center consistent with previous laser treatment. A small, well-demarcated area of hy-perfluorescence superior to the fovea exhibited increasing intensity as the angiogram progressed consistent with a neovascular membrane.
A vertical OCT image (C) through fixation displayed the contour of the fovea 1 pit, Inferior to the center, there was increased backscattering from the layers below the retinal pigment epithelium (RPE) consistent with a laser scar. The reflection from the RPE and choriocapillaris adjacent to the scar immediately superior to the fovea appeared to be fragmented corresponding to the neovascular membrane observed clinically
Was this article helpful?