Presumed ocular histoplasmosis syndrome POHS is a retinal condition linked to previous infection with the fungus Histoplasma capsulatum. It can cause sight-threatening choroidal neovascularisation near the macula.
Features and symptoms
Most people with POHS have no active infection, only old scars. Vision changes occur if new vessels form.
- Punched-out atrophic scars in the mid-periphery and around the optic disc
- Absence of significant vitreous inflammation
- Distortion or central blur when choroidal neovascular membranes develop
- More common in people from histoplasmosis-endemic regions
Treatment
Management focuses on treating any choroidal neovascularisation and monitoring the fellow eye.
- Intravitreal anti-VEGF injections for active neovascular membranes
- OCT and angiography to guide treatment and follow-up
- Self-monitoring with an Amsler grid to detect new distortion
- Low-vision support if central scarring is advanced
