Aetiological study of the presumed ocular histoplasmosis syndrome in the Netherlands

Aim-To investigate whether presumed ocular histoplasmosis syndrome in the N etherlands is caused by Histoplasma capsulatum and whether other risk facto rs might play a role in the pathogenesis of this syndrome. Methods-23 patients were clinically diagnosed as having presumed ocular his toplasmosis syndrome based on the following criteria: peripapillary atrophy , punched out lesions, a macular disciform lesion or scar in one eye withou t vitritis. As controls, 66 sex and age matched healthy volunteers were use d. Serum samples from both patients and controls were tested for the presen ce of antibodies against N capsulatum, Toxoplasma gondii, Toxocara canis et cati, Ascaris sp, and for the presence of antigens of Cryptococcus neoform ans. Serum samples were also tested for the presence of autoantibodies agai nst retinal or choroidal proteins. To investigate other risk factors, patie nts and controls were asked to fill in a health and travel related question naire. Ten patients with ocular toxoplasmosis were used as a disease contro l group. Results-None of the patients with presumed ocular histoplasmosis syndrome o r controls had circulating antibodies directed against H capsulatum. No ris k factors could be identified and no indications for autoimmunity and no ev idence for the role of the other infectious agents could be demonstrated. Conclusions-In a Dutch group of patients fulfilling the criteria of a disea se currently named presumed ocular histoplasmosis syndrome, no risk factors or relation with the fungus H capsulatum could be detected.