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Histoplasmosis of the eye: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Histoplasmosis of the eye is a disease caused by the fungus Histoplasnia capsulatum, which exists in two forms: in humans - as a yeast, in contaminated soil - as a mold. It is most often found in endemic areas (USA - the states of Mississippi, Florida, Texas; Central America, Central Africa, etc.). Infection occurs when spores are inhaled into the lungs. Various organs can be involved in the pathological process, and then we talk about systemic histoplasmosis.
[ Symptoms and diagnosis of histoplasmosis of the eye
Characteristic ophthalmoscopic signs are chorioretinal atrophy foci, cystic changes in the macula, peripapillary scars, choroidal neovascularization, linear bands on the midperiphery, and the 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. It is believed that a genetic predisposition is necessary for the formation of atrophic foci and the formation of a subretinal peovascular membrane. Choroidal neovascularization as a complication often occurs in patients with atrophic foci in the macular region, which has a color from red to gray, appears thickened, with a ring of hyperpigmentation, which is believed to be a compensatory response of the pigment epithelium. In this case, a significant decrease in visual acuity is noted. Ophthalmoscopically, hemorrhagic detachment of the neuroepithelium and pigment epithelium in the macular region is often detected. The presence of neovascularization is confirmed by the results of angiography.
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Treatment of histoplasmosis of the eye
In case of neovascularization of the choroid, krypton laser photocoagulation is indicated, however, significant subfoveal growth of vessels complicates treatment, since photocoagulation of this zone leads to irreversible vision loss.