Multifocal choroiditis and panuveitis. A syndrome that mimics ocular histoplasmosis

Abstract

A review of 28 cases of multifocal choroiditis with vitreous inflammatory cells demonstrates that these patients have chorioretinal scars similar to those in the presumed ocular histoplasmosis syndrome (POHS), but they have a low incidence of positive histoplasmin skin test reactions and calcified granulomata on chest x-ray films. Anterior chamber inflammation is a frequent finding. The epidemiologic background of these patients is different from those with POHS. The subjects in this study were also different from patients with birdshot or vitiliginous choroiditis and acute posterior multifocal placoid pigment epitheliopathy. However, unilateral cases are difficult to distinguish from cases of diffuse unilateral subacute neuroretinitis. While it is possible that a subretinal nematode may have caused some of the unilateral cases in this review, multiple causative agents are likely, including an unidentified agent that causes cross reactions to histoplasmin skin tests.