A 25-year-old woman presented with decreased visual acuity in her left eye (20/40). Fundoscopic examination (Figure 1A, 1B), fluorescein angiography (Figure 1C), and optical coherence tomography (Figure 1D) demonstrated findings consistent with presumed ocular histoplasmosis syndrome, a condition typically reported in endemic regions of the United States. The characteristic triad—peripapillary atrophy, multiple "histo spots" (yellow arrows), and a choroidal neovascular membrane (red asterisk)—was identified in the absence of intraocular inflammation or systemic manifestations. These findings supported the diagnosis of presumed ocular histoplasmosis syndrome despite the nonendemic geographic setting. This case represents a rare phenocopy of presumed ocular histoplasmosis syndrome in Brazil^(1,2).

REFERENCES

1. Suttorp-Schulten MS, Bollemeijer JG, Bos PJ, Rothova A. Presumed ocular histoplasmosis in Netherlands – an area without histoplasmosis. Br J Ophthalmol. 1997;81(1):7–11.

2. Amaro MH, Muccioli C, Abreu MT. Ocular histoplasmosis-like syndrome: a report of a non-endemic area. Arq Bras Oftalmol. 2007;70(4):577–80.

Data Availability Statement: The datasets generated and/or analyzed during the current study are included in the manuscript.

Edited by:
Editor-in-Chief: Newton Kara-Júnior
Associate Editor: Carlos Augusto Moreira Neto

Submitted for publication: November 25, 2025.
Accepted for publication: February 10, 2026.

Funding: This study received no specific financial support.

Disclosure of potential conflicts of interest: The authors declare no potential conflicts of interest.