Korean J Ophthalmol.  2012 Feb;26(1):58-60. 10.3341/kjo.2012.26.1.58.

A Case of Ocular Toxoplasmosis Imaged with Spectral Domain Optical Coherence Tomography

• Cho DY
• Nam W

• KMID: 1120184
• DOI: http://doi.org/10.3341/kjo.2012.26.1.58

Abstract

A 54-year-old man presented with blurred central vision in the right eye of two weeks' duration. On presentation, visual acuity was 40 / 50 in the right eye and fundus examination showed a whitish-yellow inflammatory lesion near an atrophic, pigmented retinochoroidal scar located in the superotemporal quadrant. Serologic assessment was negative for IgM, but serum IgG to toxoplasma was elevated. Spectral domain optical coherence tomography (SD-OCT) revealed increased reflectivity from the inner retinal layer, retinal thickening, and choroidal shadowing while focal posterior hyaloid thickening and detachment were observed in the new lesion. He was treated with trimethoprim/sulfamethoxazole, clindamycin, and prednisone. SD-OCT is helpful for definitively differentiating ocular toxoplasmosis from other retinal diseases.

Keyword

Ocular toxoplasmosis; Retinochoroiditis; Spectral domain optical coherence tomography

MeSH Terms

Diagnosis, Differential
Humans
Male
Middle Aged
Tomography, Optical Coherence/*methods
Toxoplasmosis, Ocular/*diagnosis/drug therapy
Visual Acuity

Figure

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  Fig. 1 (A) Hyperfluorescence was observed at the margin of the old lesion and in the new lesion on early phase fluorescein angiography. (B) The new lesion showed hyperfluorescence in the late-phase.

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  Fig. 2 (A) Fundus photography revealed a whitish-yellow inflammatory lesion near an atrophic, pigmented retinochoroidal scar located in the superotemporal quadrant. (B) Spectral domain optical coherence tomography showed increased reflectivity from the inner retinal layer, retinal thickening and choroidal shadowing. Focal posterior hyaloid thickening and detachment were also observed (arrow). (C) Hyperreflectivity, thinning of the neurosensory retina and a disorganized retinal pigment epithelium layer were observed.

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  Fig. 3 (A) The lesion resolved and had a scar-like appearance. (B) Spectral domain optical coherence tomography showed thinning of the retina, loss of normal striations, and a disorganized retinal pigment epithelium layer in addition to posterior hyaloid detachment (arrow).

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