Ocular Histoplasmosis Syndrome - Macular Scar - Active CNVM
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56-year-old man has ocular histoplasmosis in both eyes and multiple laser scars and macular scarring. His right eye unfortunately has been poor for sometime, recently, despite efforts with subretinal surgery in 2007 to preserve the vision. The left eye is doing fine. He did notice a change in his reading vision, just when I saw him back in November and the OCT scans suggested a small area of subretinal fluid just temporal to the fovea in his better eye. His vision remains good in that eye.
VISUAL ACUITY: OD 5/200, OS 20/16. IOP: OD 17, OS 16.
SLIT EXAMINATION: The right eye has a posterior chamber intraocular lens in good position. The left eye has 2+ nuclear sclerosis.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.6. There is a macular scar.
OS: Vertical C/D ratio is 0.3. There is a juxtapapillary scar. There are patchy pigment epithelial detachments temporal to the fovea. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows staining macular scar in the right eye and juxtafoveal scar in the left eye. There is no evidence of any leakage from either scar. There is a pigment epithelial detachment on the inferotemporal edge of the fovea in the left eye, which corresponds to the small area where the subretinal fluid was last visit. That appears today to not be leaking.
IMPRESSION:
1. OCULAR HISTOPLASMOSIS – BOTH EYES
2. MULTIPLE PIGMENT EPITHELIAL DETACHMENTS – BOTH EYES
3. MACULAR SCARS – BOTH EYES
DISCUSSION: I explained to the patient the maculae today look stable. I asked him to return here for a check urgently should he notice a striking change in either eye, otherwise he will return again in three to six months. Thank you for allowing me to participate in his care.
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56-year-old man has ocular histoplasmosis in both eyes and multiple laser scars and macular scarring. His right eye unfortunately has been poor for sometime, recently, despite efforts with subretinal surgery in 2007 to preserve the vision. The left eye is doing fine. He did notice a change in his reading vision, just when I saw him back in November and the OCT scans suggested a small area of subretinal fluid just temporal to the fovea in his better eye. His vision remains good in that eye.
VISUAL ACUITY: OD 5/200, OS 20/16. IOP: OD 17, OS 16.
SLIT EXAMINATION: The right eye has a posterior chamber intraocular lens in good position. The left eye has 2+ nuclear sclerosis.
EXTENDED OPHTHALMOSCOPY:
OD: Vertical C/D ratio is 0.6. There is a macular scar.
OS: Vertical C/D ratio is 0.3. There is a juxtapapillary scar. There are patchy pigment epithelial detachments temporal to the fovea. Photos confirm clinical findings.
FLUORESCEIN ANGIOGRAPHY: Fluorescein angiography shows staining macular scar in the right eye and juxtafoveal scar in the left eye. There is no evidence of any leakage from either scar. There is a pigment epithelial detachment on the inferotemporal edge of the fovea in the left eye, which corresponds to the small area where the subretinal fluid was last visit. That appears today to not be leaking.
IMPRESSION:
1. OCULAR HISTOPLASMOSIS – BOTH EYES
2. MULTIPLE PIGMENT EPITHELIAL DETACHMENTS – BOTH EYES
3. MACULAR SCARS – BOTH EYES
DISCUSSION: I explained to the patient the maculae today look stable. I asked him to return here for a check urgently should he notice a striking change in either eye, otherwise he will return again in three to six months. Thank you for allowing me to participate in his care.
