PMID: 1205676Jan 11, 1975Paper

Diagnosis and management of minimal recurrences of macular histoplasmosis

International Ophthalmology Clinics
T F Schlaegel

Abstract

Disease in the macula from ocular histoplasmosis has been ascribed to (1) traction of a scar, (2) fresh areas of choroiditis, and (3) reactivation of a scar. Traction of a scar is probably a rare cause. The rationale for early use of corticosteroids in attacks of ocular histoplasmosis is based on the hypothesis that the underlying disease is an inflammation. The concept of a choroiditis could fit with what is assumed to happen in the case of second and third hypotheses, those of fresh choroiditis and reactivation of a scar. The goal of therapy is to stop the inflammation before it is clinically recognizable by the ophthalmologist, so that little or no damage to vision results. Whether corticosteroids might work by suppression of an immunological response or simply by curtailing the severity of the choroiditis, or both, is not known. We do know from clinical experience that corticosteroids do not appear to be deleterious to the ocular histoplasmosis. When they were first tried, we were wary about using them in a "fungal" disease. As experience grew, we learned that our mistakes were usually not from using too great a quantity of corticosteroids for too long a time but the opposite; from using too small amounts of corticosteroids...Continue Reading

Citations

May 5, 2005·Current Opinion in Ophthalmology·Alejandro OliverGrant M Comer

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