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Histoplasmosis of the eye: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Histoplasmosis of the eye is a disease caused by the fungus Histoplasnia capsulatum, which exists in two forms: in man - in yeast, in contaminated soil - in the form of mold. The bowl is found in endemic areas (USA - the states of Mississippi, Florida, Texas, Central America, Central Africa, etc.). Infection occurs by inhalation of spores into the lungs. Various organs can be involved in the pathological process, and then they speak of systemic histoplasmosis.
[Symptoms and Diagnosis of Histoplasmosis of the Eyes
Typical ophthalmoscopic signs are chorioretinal foci of atrophy, cystic changes in the macula, peripapillary scars, choroidal neovascularization, linear bands on the middle periphery, absence of clinical signs of an active inflammatory process.
The skin test for histoplasmosis is positive. At the same time, there are phenotypic forms of histoplasmosis, in which the skin test is often negative. In such cases, diagnosis becomes difficult. There is an opinion that a genetic predisposition is necessary for the formation of atrophic foci and the formation of the subretinal peovascular membrane. Choroidal neovascularization as a complication of the bowl occurs in patients with atrophic foci in the macular area, which has a color from red to gray, appears thickened, with a hyperpigmentation ring, which is considered to be the compensatory response of the pigmental antibody. At the same time there is a significant decrease in visual acuity. Ophthalmoscopically often reveal hemorrhagic detachment of neuroepithelium and pigment epithelium in the macular area. The presence of neovascularization confirms the results of angiography.
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Treatment of histoplasmosis of the eye
With neovascularization of the choroid, krypton laser photocoagulation is indicated, however, a significant subfoveal growth of the vessels complicates the treatment, as the photocoagulation of this zone leads to an irreversible decrease in vision.