Ocular histoplasmosis-like syndrome: a report from a nonendemic area.

PURPOSE To report some cases of ocular histoplasmosis-like syndrome from a nonendemic area. DESIGN Observational case series. METHODS This is a prospective study of 16 eyes from 8 immunocompetent patients evaluated between January 2001 to September 2005. Six patients were female and 2 male aged between 20 to 44 years, average 28 years. All patients presented clinical features that resembled ocular histoplasmosis. All patients had a negative antibody test for histoplasmosis and negative medical and laboratory evaluation of toxoplasmosis, syphilis, and tuberculosis. All patients were submitted to a complete ocular examination including fluorescein angiography. One patient was submitted to indocyanine green angiography. RESULTS Five patients presented the classical triad of clinical features that include peripapillary scarring, histo spots, choroidal neovascularization, one patient presented enlargement of atrophic chorioretina scar, one patient presented multiple retinal pigment epithelial detachment, one, neovascularized retinal pigment epithelial detachment. Another patient presented only histo spots. CONCLUSION These findings of ocular histoplasmosis-like syndrome in patients with negative antibody serum test from a nonendemic area suggest that other agents could cause these similar fundus findings of ocular histoplasmosis.