Zusammenfassung
Hintergrund: Das Presumed-Ocular-Histoplasmosis-Syndrom (POHS) ist eine in nichtendemischen Arealen
selten auftretende chorioretinale Erkrankung. Methoden: Wir präsentieren einen 35-jährigen männlichen Patienten mit Sicca-Symptomatik, aber
subjektiv keinen weiteren Augenbeschwerden. Die Sehschärfe des rechten Auges betrug
1,0, des linken 0,1. Ergebnisse: Bei der Fundusuntersuchung zeigten sich Veränderungen, die alle vier typischen Zeichen
des POHS erfüllen. In beiden Augen fanden sich in der mittleren Peripherie ausgestanzte
chorioretinale Herde, eine extensive peripapilläre Atrophie sowie periphere chorioretinale
lineare Streifen. Am linken Auge bestand zusätzlich eine atrophische Makulanarbe,
vermutlich nach CNV. Die Makula des rechten Auges war regelrecht, die durchgeführte
Serologie für Histoplasma capsulatum negativ. Schlussfolgerungen: Da sich der Patient niemals in einem Endemiegebiet wie den Vereinigten Staaten aufgehalten
hatte, aber alle charakteristischen Zeichen des POHS zeigt, kann dieses Syndrom auch
in europäischen, nichtendemischen Gebieten auftreten. Das unterstützt die Theorie,
dass andere Faktoren eine Rolle in der Ätiopathologie des POHS-Syndroms spielen.
Abstract
Background: POHS is a chorioretinal disease rarely occurring in non-endemic areas. Methods: We present the case of a 35-year old male patient with symptoms of dry eyes, but
subjectively no other ocular complaints. However, visual acuity of the right eye was
20/20, but only 20/200 in the left eye. Results: On fundoscopic examination both eyes showed alterations consistent with all four
typical features of presumed ocular histoplasmosis syndrome. In both eyes in the mid-periphery
punched-out chorioretinal spots were found, an extensive peripapillary atrophy and
peripheral linear chorioretinal streaks were seen. Moreover, in the left eye an atrophic
macular scar existed, presumably due to subretinal neovascularisation. The macula
of the right eye was normal, serology testing for Histoplasma capsulatum negative.
Conclusions: As the patient had never travelled to endemic areas such as the USA but exhibited
all features of POHS, the case shows that POHS may also occur in European, non-endemic
areas. This further supports the theory that other factors play a role in the etiopathology
of this syndrome.
Schlüsselwörter
Presumed-Ocular-Histoplasmosis-Syndrom - chorioidale Neovaskularisation (CNV)
Key words
Presumed ocular histoplasmosis syndrome - choroidal neovascularisation
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Christos Chryssafis
Augenklinik der Ludwig-Maximilians-Universität
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