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visible; "be sure of it; give me the ocular proof"- Shakespeare; "a visual presentation"; "a visual image" (同)visual
of or relating to or resembling the eye; "ocular muscles"; "an ocular organ"; "ocular diseases"; "the optic (or optical) axis of the eye"; "an ocular spot is a pigmented organ or part believed to be sensitive to light" (同)optic, optical, opthalmic
relating to or using sight; "ocular inspection"; "an optical illusion"; "visual powers"; "visual navigation" (同)optic, optical, visual

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/02 21:45:23」(JST)

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Retinal photograph of ocular histoplasmosis

Presumed ocular histoplasmosis syndrome (POHS) is a syndrome affecting the eye, which is characterized by peripheral atrophic chorioretinal scars, atrophy or scarring adjacent to the optic disc and maculopathy.

The loss of vision in POHS is caused by choroidal neovascularization.

Causes

Despite its name, the "presumed" relationship of POHS to Histoplasma capsulatum is controversial.^[1]^[2] The fungus has rarely been isolated from cases with POHS,^[3]^{[medical citation needed]} the condition has also been found in locations where histoplasmosis is rare,^[4] and there appears to be a relationship with tobacco smoking.^{[medical citation needed]}

Presentation

The diagnosis of POHS is based on the clinical triad of multiple white, atrophic choroidal scars, peripapillary pigment changes (dark spots around optic disc of the eye), and a maculopathy caused by choroidal neovascularization.

Completely distinct from POHS, acute ocular histoplasmosis may rarely occur in immunodeficiency.^[5]^[6]

Diagnosis

Fluorescein angiography is usually performed for diagnosis and follow-up of patients with POHS.

Treatment

Treatment requires careful consideration of angiographic findings when a choroidal neovascular membrane is suspected which is a condition that responds to treatment. A vitreo-retinal specialist (an ophthalmologist specialized in treatment of retinal diseases) should be consulted for proper management of the case.

Presumed ocular histoplasmosis syndrome and age-related macular degeneration (AMD) have been successfully treated with laser, anti-vascular endothelial growth factors and photodynamic therapy. Ophthalmologists are using anti-vascular endothelial growth factors to treat AMD and similar conditions since research indicates that vascular endothelial growth factor (VEGF) is one of the causes for the growth of the abnormal vessels that cause these conditions.

References

^ Thuruthumaly, C; Yee, D. C.; Rao, P. K. (2014). "Presumed ocular histoplasmosis". Current Opinion in Ophthalmology 25 (6): 508–12. doi:10.1097/ICU.0000000000000100. PMID 25237930
^ Nielsen, J. S.; Fick, T. A.; Saggau, D. D.; Barnes, C. H. (2012). "Intravitreal anti-vascular endothelial growth factor therapy for choroidal neovascularization secondary to ocular histoplasmosis syndrome". Retina 32 (3): 468–72. doi:10.1097/IAE.0b013e318229b220. PMID 21817958
^ [1] Presumed Ocular Histoplasmosis Syndrome
^ Stefan Dithmar; Frank Gerhard Holz (28 April 2008). Fluorescence Angiography in Ophthalmology. Springer. pp. 168–. ISBN 978-3-540-78359-6. Retrieved 29 June 2010.
^ Macher, A; Rodrigues, M. M.; Kaplan, W; Pistole, M. C.; McKittrick, A; Lawrinson, W. E.; Reichert, C. M. (1985). "Disseminated bilateral chorioretinitis due to Histoplasma capsulatum in a patient with the acquired immunodeficiency syndrome". Ophthalmology 92 (8): 1159–64. PMID 2413418
^ Gonzales, C. A.; Scott, I. U.; Chaudhry, N. A.; Luu, K. M.; Miller, D; Murray, T. G.; Davis, J. L. (2000). "Endogenous endophthalmitis caused by Histoplasma capsulatum var. Capsulatum: A case report and literature review". Ophthalmology 107 (4): 725–9. doi:10.1016/s0161-6420(99)00179-7. PMID 10768335.
^ Ehrlich R, Ciulla TA, Maturi R, et al. (2009). "Intravitreal bevacizumab for choroidal neovascularization secondary to presumed ocular histoplasmosis syndrome". Retina (Philadelphia, Pa.) 29 (10): 1418–23. doi:10.1097/IAE.0b013e3181babdf1. PMID 19898179.

UpToDate Contents

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1. 播種性ヒストプラスマ症の病因および臨床症状 pathogenesis and clinical manifestations of disseminated histoplasmosis
2. 非HIV感染患者における播種性ヒストプラスマ症の診断および治療 diagnosis and treatment of disseminated histoplasmosis in non hiv infected patients
3. 眼内出血リスクの高い患者における抗凝固療法、抗血小板療法、および線維素溶解（
血栓溶解）療法 anticoagulant antiplatelet and fibrinolytic thrombolytic therapy in patients at high risk for ocular hemorrhage
4. HIV感染患者におけるヒストプラスマ症の疫学および臨床症状 epidemiology and clinical manifestations of histoplasmosis in hiv infected patients
5. 肺ヒストプラスマ症の診断および治療 diagnosis and treatment of pulmonary histoplasmosis

English Journal

Investigation of Choroidal Neovascularization Risk Alleles in Ocular Histoplasmosis.

Wilkes MF1, Miller DM1, Mitchell MD2, Zanke B3, Petersen MR2, Sisk RA1, Riemann CD1, Foster RE2.
Ophthalmology.Ophthalmology.2014 Mar 5. pii: S0161-6420(14)00016-5. doi: 10.1016/j.ophtha.2013.01.079. [Epub ahead of print]
PMID 24612979

Intravitreal ranibizumab in the treatment of subretinal neovascularization in a case of punctate inner choroidopathy.

Jiménez B1, Pinilla I2, Cristóbal JA2, Mínguez E2, Pérez D2, Cruz N2, Peiro C2.Author information 1Servicio de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España. Electronic address: bea83jdm@hotmail.com.2Servicio de Oftalmología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.AbstractCASE REPORT: We report the case of a 28-year old woman suffering loss of visual acuity in her left eye, who presented an image suggestive of a subretinal neovascular membrane in her left eye, and bilateral retinal lesions compatible with punctate inner choroidopathy (PIC). She was treated with intravitreal ranibizumab obtaining excellent results.
Archivos de la Sociedad Espanola de Oftalmologia.Arch Soc Esp Oftalmol.2014 Mar;89(3):130-132. doi: 10.1016/j.oftal.2012.11.008. Epub 2012 Dec 28.
CASE REPORT: We report the case of a 28-year old woman suffering loss of visual acuity in her left eye, who presented an image suggestive of a subretinal neovascular membrane in her left eye, and bilateral retinal lesions compatible with punctate inner choroidopathy (PIC). She was treated with intra
PMID 24269388

Imaging characteristics of neovascular pigment epithelial detachments and their response to anti-vascular endothelial growth factor therapy.

Punjabi OS1, Huang J, Rodriguez L, Lyon AT, Jampol LM, Mirza RG.Author information 1Department of Ophthalmology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611, USA.AbstractPURPOSE: To evaluate the imaging characteristics of macular neovascular pigment epithelial detachments (PEDs) and their response to anti-vascular endothelial growth factor (VEGF) therapy.
The British journal of ophthalmology.Br J Ophthalmol.2013 Aug;97(8):1024-31. doi: 10.1136/bjophthalmol-2013-303155. Epub 2013 Jun 12.
PURPOSE: To evaluate the imaging characteristics of macular neovascular pigment epithelial detachments (PEDs) and their response to anti-vascular endothelial growth factor (VEGF) therapy.METHODS: Patients with exudative age-related macular degeneration (AMD), idiopathic polypoidal choroidal vasculop
PMID 23759437

Japanese Journal

中心性滲出性脈絡網膜症早期症例の治療

日本眼科紀要 = Folia ophthalmologica Japonica 50(5), 386-389, 1999-05-28
NAID 10009939604

Distribution of growth factors in subfoveal neovascular membranes in age - related macular degeneration and presumed ocular histoplasmosis syndrome

Am J Ophthalmol 120, 291-301, 1995
NAID 10007891879

Surgical removal of subfoveal neovascularization in the presumed ocular histoplasmosis syndrome

Am J Ophthalmol 111, 1-7, 1991
NAID 10010218697

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★リンクテーブル★

リンク元	「眼ヒストプラスマ症」「眼ヒストプラズマ症」
拡張検索	「presumed ocular histoplasmosis syndrome」
関連記事	「ocular」