The presumed ocular histoplasmosis syndrome (POHS) occurs in areas of the USA in which Histoplasma capsulatumis endemic. The ocular triad of POHS consists of peripheral punched out chorioretinal scars, peripapillary atrophy, and maculopathy. The maculopathy most frequently consists of a subretinal neovascular complex associated with a previous focal chorioretinal scar. Vitritis is not observed in POHS.

The characteristic ocular presentation was associated with infection with H capsulatum through epidemiological studies.12 However, only rarely has the H capsulatum antigen and organism been identified in an eye with POHS. Khalil enucleated an eye with choroidal melanoma and demonstrated chorioretinal foci with various stages of chronic inflammation in which both the antigen …