OHS is a major cause of visual impairment
in the eastern and central United States where 90 percent
of adults have been exposed to histoplasma capsulatum.
This common fungus is found in molds from soil enriched
with bat, chicken or starling droppings and yeasts from
animals.
Although the fungus is not found directly in the eye,
people with OHS usually test positive for previous exposure
to histoplasma capsulatum.
Histoplasmosis is usually mistaken for a cold. The
symptoms are very similar. The body's immune system
normally overcomes the infection in a few days. The
only evidence of histoplasmosis is histo spots, tiny
scars on the retina. Generally histo spots do not affect
vision, but for unknown reasons, some people can have
ocular complications years or decades later.
Doctors believe that the histoplasmosis spores travel
from the lungs to the eye where they settle in the choroid,
the layer of tiny blood vessels that provides blood
and nutrients to the retina, the light-sensing layer
of cells lining the back of the eye.
Ocular histoplasmosis develops when fragile, abnormal
blood vessels grow under the retina. The abnormal blood
vessels form a lesion known as choroidal neovascularization
(CNV). If left untreated, the CNV lesion can turn into
scar tissue and replace the normal retinal tissue in
the macula.
The only proven treatment for OHS is a form of laser
surgery called photocoagulation. The laser's small,
powerful beam of light destroys the abnormal blood vessels,
as well as a small amount of the retinal tissue. Treatment
is not necessary unless the new vessels are in the macula,
the part of the retina responsible for acute central
vision.
Although only a tiny fraction of people infected with
the histoplasmosis virus develop OHS, if you have been
exposed to histoplasmosis you should be sensitive to
any changes in your eyesight. |