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

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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.

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.

참고문헌 (5)

  1. McCannel CA, "Causes of uveitis in the general practice of ophthalmology", Am J Ophthalmol, 121, pp.35~46 (1996), UCLA Community-Based Uveitis Study Group
  2. Pierce EA, "Ocular toxoplasmosis: pathogenesis, diagnosis, and management", Semin Ophthalmol, 8, pp.40~52 (1993)
  3. Smith JR, "Atypical presentations of ocular toxoplasmosis", Curr Opin Ophthalmol, 13, pp.387~392 (2002)
  4. Singh M, "Spectral domain optical coherence tomography imaging of retinal diseases in Singapore", Ophthalmic Surg Lasers Imaging, 40, pp.336~341 (2009)
  5. Orefice JL, "Vitreoretinal morphology in active ocular toxoplasmosis: a prospective study by optical coherence tomography", Br J Ophthalmol, 91, pp.773~780 (2007)

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