Aetiological study of the presumed ocular histoplasmosis syndrome in the Netherlands
a Department of
Ophthalmo-Immunology, Netherlands Ophthalmic Research Institute,
Amsterdam, Netherlands, b Department of
Ophthalmology, Academic Medical Centre, Amsterdam, Netherlands, c Diagnostic Laboratory for Infectious Diseases
and Perinatal Screening, National Institute of Public Health and the
Environment, Bilthoven, Netherlands, d Department
of Ophthalmology, F C Donders Institute, University Hospital
Utrecht, Netherlands, e Department of Ophthalmology, Diaconnessenhuis,
Leiden, Netherlands
Correspondence to: Jenny V Ongkosuwito, Netherlands Ophthalmic Research Institute, Department of Ophthalmo-Immunology, PO Box 12141, 1100 AC Amsterdam, Netherlands.
Accepted for publication 25 November 1998
AIM
To investigate
whether presumed ocular histoplasmosis syndrome in the Netherlands is
caused by Histoplasma capsulatum and whether
other risk factors might play a role in the pathogenesis of this syndrome.
METHODS23 patients
were clinically diagnosed as having presumed ocular histoplasmosis
syndrome based on the following criteria: peripapillary atrophy,
punched out lesions, a macular disciform lesion or scar in one eye
without vitritis. As controls, 66 sex and age matched healthy
volunteers were used. Serum samples from both patients and controls
were tested for the presence of antibodies against H capsulatum, Toxoplasma
gondii, Toxocara
canis et cati,
Ascaris sp, and for the presence of antigens
of Cryptococcus neoformans. Serum samples
were also tested for the presence of autoantibodies against retinal or
choroidal proteins. To investigate other risk factors, patients and
controls were asked to fill in a health and travel related
questionnaire. Ten patients with ocular toxoplasmosis were used as a
disease control group.
RESULTSNone of the
patients with presumed ocular histoplasmosis syndrome or controls had
circulating antibodies directed against H
capsulatum. No risk factors could be identified and no
indications for autoimmunity and no evidence for the role of the other
infectious agents could be demonstrated.
CONCLUSIONSIn a Dutch
group of patients fulfilling the criteria of a disease currently named
presumed ocular histoplasmosis syndrome, no risk factors or relation
with the fungus H capsulatum could be detected.
© 1999 by British Journal of Ophthalmology
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