Importance of proper diagnosis for management: Multifocal choroiditis mimicking ocular histoplasmosis syndrome

Elham Hatef, Peykan Turkcuoglu, Mohamed Ibrahim, Yasir Sepah, Matthew Shulman, Jangwon Heo, Jeong Hee Lee, Roomasa Channa, Afsheen Khwaja, Zubir Rentiya, Syed Mahmood Shah, Diana V. Do, Quan Dong Nguyen

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Purpose: The study aims to evaluate a series of patients with initial diagnosis of ocular histoplasmosis syndrome (OHS) with progression and response to treatments consistent with multifocal choroiditis (MFC). Methods: Retrospective review of nine patients referred for management of recurrent OHS lesions. Serology panel was conducted to rule out autoimmune and infectious causes. Results: Clinical examination revealed multiple small, punched-out peripheral chorioretinal scars, and peripapillary atrophy. Histoplasma antigen/antibody was negative in all patients. Fluorescein angiography and optical coherence tomography confirmed active inflammation in five patients. Immunomodulatory therapy (IMT) was initiated to control active inflammation. While on IMT, visual acuity stabilized or improved in three patients with no recurrence of CNV or lesion activities over the follow-up period. Conclusions: MFC may initially masquerade as OHS. Clinical characteristics of recurrent MFC and absence of histoplasma titer may lead to consideration of IMT and other proper treatments for MFC.

Original languageEnglish (US)
Pages (from-to)55-63
Number of pages9
JournalJournal of Ophthalmic Inflammation and Infection
Volume1
Issue number2
DOIs
StatePublished - Jun 1 2011

Fingerprint

Histoplasmosis
Immunomodulation
Histoplasma
Inflammation
Fluorescein Angiography
Optical Coherence Tomography
Serology
Visual Acuity
Atrophy
Cicatrix
Multifocal choroiditis
Antigens
Recurrence
Antibodies
Therapeutics

Keywords

  • Multifocal choroiditis
  • Ocular histoplasmosis syndrome

ASJC Scopus subject areas

  • Ophthalmology
  • Infectious Diseases

Cite this

Importance of proper diagnosis for management : Multifocal choroiditis mimicking ocular histoplasmosis syndrome. / Hatef, Elham; Turkcuoglu, Peykan; Ibrahim, Mohamed; Sepah, Yasir; Shulman, Matthew; Heo, Jangwon; Lee, Jeong Hee; Channa, Roomasa; Khwaja, Afsheen; Rentiya, Zubir; Shah, Syed Mahmood; Do, Diana V.; Nguyen, Quan Dong.

In: Journal of Ophthalmic Inflammation and Infection, Vol. 1, No. 2, 01.06.2011, p. 55-63.

Research output: Contribution to journalReview article

Hatef, E, Turkcuoglu, P, Ibrahim, M, Sepah, Y, Shulman, M, Heo, J, Lee, JH, Channa, R, Khwaja, A, Rentiya, Z, Shah, SM, Do, DV & Nguyen, QD 2011, 'Importance of proper diagnosis for management: Multifocal choroiditis mimicking ocular histoplasmosis syndrome', Journal of Ophthalmic Inflammation and Infection, vol. 1, no. 2, pp. 55-63. https://doi.org/10.1007/s12348-010-0016-4
Hatef, Elham ; Turkcuoglu, Peykan ; Ibrahim, Mohamed ; Sepah, Yasir ; Shulman, Matthew ; Heo, Jangwon ; Lee, Jeong Hee ; Channa, Roomasa ; Khwaja, Afsheen ; Rentiya, Zubir ; Shah, Syed Mahmood ; Do, Diana V. ; Nguyen, Quan Dong. / Importance of proper diagnosis for management : Multifocal choroiditis mimicking ocular histoplasmosis syndrome. In: Journal of Ophthalmic Inflammation and Infection. 2011 ; Vol. 1, No. 2. pp. 55-63.
@article{1f7ee573e62f45dd81c5b10f95fd7e83,
title = "Importance of proper diagnosis for management: Multifocal choroiditis mimicking ocular histoplasmosis syndrome",
abstract = "Purpose: The study aims to evaluate a series of patients with initial diagnosis of ocular histoplasmosis syndrome (OHS) with progression and response to treatments consistent with multifocal choroiditis (MFC). Methods: Retrospective review of nine patients referred for management of recurrent OHS lesions. Serology panel was conducted to rule out autoimmune and infectious causes. Results: Clinical examination revealed multiple small, punched-out peripheral chorioretinal scars, and peripapillary atrophy. Histoplasma antigen/antibody was negative in all patients. Fluorescein angiography and optical coherence tomography confirmed active inflammation in five patients. Immunomodulatory therapy (IMT) was initiated to control active inflammation. While on IMT, visual acuity stabilized or improved in three patients with no recurrence of CNV or lesion activities over the follow-up period. Conclusions: MFC may initially masquerade as OHS. Clinical characteristics of recurrent MFC and absence of histoplasma titer may lead to consideration of IMT and other proper treatments for MFC.",
keywords = "Multifocal choroiditis, Ocular histoplasmosis syndrome",
author = "Elham Hatef and Peykan Turkcuoglu and Mohamed Ibrahim and Yasir Sepah and Matthew Shulman and Jangwon Heo and Lee, {Jeong Hee} and Roomasa Channa and Afsheen Khwaja and Zubir Rentiya and Shah, {Syed Mahmood} and Do, {Diana V.} and Nguyen, {Quan Dong}",
year = "2011",
month = "6",
day = "1",
doi = "10.1007/s12348-010-0016-4",
language = "English (US)",
volume = "1",
pages = "55--63",
journal = "Journal of Ophthalmic Inflammation and Infection",
issn = "1869-5760",
publisher = "Springer Verlag",
number = "2",

}

TY - JOUR

T1 - Importance of proper diagnosis for management

T2 - Multifocal choroiditis mimicking ocular histoplasmosis syndrome

AU - Hatef, Elham

AU - Turkcuoglu, Peykan

AU - Ibrahim, Mohamed

AU - Sepah, Yasir

AU - Shulman, Matthew

AU - Heo, Jangwon

AU - Lee, Jeong Hee

AU - Channa, Roomasa

AU - Khwaja, Afsheen

AU - Rentiya, Zubir

AU - Shah, Syed Mahmood

AU - Do, Diana V.

AU - Nguyen, Quan Dong

PY - 2011/6/1

Y1 - 2011/6/1

N2 - Purpose: The study aims to evaluate a series of patients with initial diagnosis of ocular histoplasmosis syndrome (OHS) with progression and response to treatments consistent with multifocal choroiditis (MFC). Methods: Retrospective review of nine patients referred for management of recurrent OHS lesions. Serology panel was conducted to rule out autoimmune and infectious causes. Results: Clinical examination revealed multiple small, punched-out peripheral chorioretinal scars, and peripapillary atrophy. Histoplasma antigen/antibody was negative in all patients. Fluorescein angiography and optical coherence tomography confirmed active inflammation in five patients. Immunomodulatory therapy (IMT) was initiated to control active inflammation. While on IMT, visual acuity stabilized or improved in three patients with no recurrence of CNV or lesion activities over the follow-up period. Conclusions: MFC may initially masquerade as OHS. Clinical characteristics of recurrent MFC and absence of histoplasma titer may lead to consideration of IMT and other proper treatments for MFC.

AB - Purpose: The study aims to evaluate a series of patients with initial diagnosis of ocular histoplasmosis syndrome (OHS) with progression and response to treatments consistent with multifocal choroiditis (MFC). Methods: Retrospective review of nine patients referred for management of recurrent OHS lesions. Serology panel was conducted to rule out autoimmune and infectious causes. Results: Clinical examination revealed multiple small, punched-out peripheral chorioretinal scars, and peripapillary atrophy. Histoplasma antigen/antibody was negative in all patients. Fluorescein angiography and optical coherence tomography confirmed active inflammation in five patients. Immunomodulatory therapy (IMT) was initiated to control active inflammation. While on IMT, visual acuity stabilized or improved in three patients with no recurrence of CNV or lesion activities over the follow-up period. Conclusions: MFC may initially masquerade as OHS. Clinical characteristics of recurrent MFC and absence of histoplasma titer may lead to consideration of IMT and other proper treatments for MFC.

KW - Multifocal choroiditis

KW - Ocular histoplasmosis syndrome

UR - http://www.scopus.com/inward/record.url?scp=84863005931&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863005931&partnerID=8YFLogxK

U2 - 10.1007/s12348-010-0016-4

DO - 10.1007/s12348-010-0016-4

M3 - Review article

C2 - 21484182

AN - SCOPUS:84863005931

VL - 1

SP - 55

EP - 63

JO - Journal of Ophthalmic Inflammation and Infection

JF - Journal of Ophthalmic Inflammation and Infection

SN - 1869-5760

IS - 2

ER -