Which of the following is NOT true regarding Histoplasmosis?

• A. It is a fungal infection
• B. It leads to "punched out" multifocal choroidal lesions
• C. It usually causes vitritis
• D. Peripapillary atrophy and CNVM are possible effects

Answer: (C)

Ocular histoplasmosis syndrome presents with peripheral punched-out choroidal lesions, often accompanied by peripapillary atrophy and the potential to develop choroidal neovascular membranes that threaten central vision. A hallmark is that the inflammation is typically mild, with little vitreous inflammation.

Vitritis is not a characteristic feature of this condition. The eye often looks relatively quiet vitreously, which helps distinguish POHS from other infectious retinochoroidal diseases where vitreous inflammation is prominent (for example, toxoplasmosis can cause more noticeable vitritis). So stating that this condition “usually causes vitritis” contradicts the usual clinical pattern, making that statement not true.

The other aspects fit well: it is caused by a fungal organism, the lesions are the punched-out choroidal spots, and peripapillary atrophy with possible CNVM can occur as complications.