How does ocular histoplasmosis syndrome clinically present?

Ocular histoplasmosis syndrome typically presents with small punched-out chorioretinal scars. These scars are a result of previous infection by the Histoplasma capsulatum fungus, which can lead to localized areas of retinal damage. These characteristic lesions are usually found in the mid-periphery of the retina and can be identified during a dilated fundus examination.

In addition to the presence of these scars, the syndrome can also lead to complications such as choroidal neovascularization, which can affect vision, but the defining feature in terms of initial clinical presentation is indeed the small chorioretinal scars. The presence of these scars is a significant diagnostic marker for ocular histoplasmosis syndrome, setting it apart from other conditions that may affect the retina.