Presumed ocular histoplasmosis syndrome. The fellow eye

H. Sawelson, R. E. Goldberg, W. H. Annesley Jr and T. L. Tomer

The fundus photographs of 308 patients with presumed ocular histoplasmosis syndrome (POHS) were examined. Bilateral macular involvement was found in 20% of the cases. The incidence of maculopathy, peripapillary lesions, and peripheral "punched-out" lesions in one fundus and only peeipapillary changes in the fellow eye was 12%. The incidence of these features in one fundus and clinically inactive, atrophic scars in the posterior pole of the fellow eye was 23%. Twenty-five patients with atrophic lesions in the macular area of the fellow eye were followed for an average of 24 months. Six patients (24%) demonstrated activation of eight previously documented atrophic lesions resulting in macular involvement. One patient also demonstrated activation from a pre-existing juxtapapillary lesion. None of the remaining 18 patients exhibited any evidence of serous or hemorrhagic retinal sequelae in the fellow eye.