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Florian Heussen, Yanling Ouyang, Qing Shao, Antonia Joussen, Uwe Pleyer; Atypical findings in Spectral Domain Optical Coherence Tomography of Ocular Toxoplasmosis with Active Lesions. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5923.
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© ARVO (1962-2015); The Authors (2016-present)
To use the spectral domain optical coherence tomography (SD-OCT) to investigate the characteristic features in patients with active ocular toxoplasmosis (OT).
Patients with OT in at least one eye who underwent SD-OCT exam using a Spectralis OCT (Heidelberg Engineering, Germany) between June 28, 2010 and November 8, 2012 were retrospectively collected. Eyes with an active lesion that OCT scans covered were included. Detailed morphological features observed by SD-OCT were evaluated at baseline.
One hundred forty four patients diagnosed with OT were reviewed. Among them, 14 eyes from 14 patients with active lesions were included (7 females). Their mean age was 35 (range, 18-35) year-old. Twelve lesions located in the macula and 11 in the fovea. Commonly reported abnormalities, including presence of vitreous cells (10 eyes), thickened hyaloid (7 eyes), epiretinal membrane (8 eyes), inner retinal layer irregularity (InRI, 7 eyes), outer retinal layer irregularity (OutRI, 10 eyes), intraretinal hyperreflective foci (7 eyes), intraretinal cystoid degeneration/cystoid macular edema (7 eyes), photoreceptor layer irregularity (10 eyes), retinal pigment epithelium (RPE) irregularity (4 eyes), RPE detachment (2 eyes), subretinal detachment (4 eyes) were observed. In addition, rare or unreported features, including spherical deposition on vitreoretinal interface (4 eyes), huge cystoid space (HCS, 4 eyes), splits in the outer photoreceptor layer (SOPRL, 3 eyes), splits in RPE/Bruch (SRPEB, 1 eye) and increased choroid intensity (ICI, 1 eye) were also found in these eyes. Regarding the involved retinal/choroidal layers, one eye with only InRI and 6 eyes with only OutRI, as well as 1 eye with only ICI without other abnormalities evaluated were observed in the study.
It is widely held that ocular toxoplasmosis involves inner retinal layers in the early course of the disease. Our findings including eyes with only OutRI or ICI were contrary to this understanding. In addition, HCS and SOPRL were not reported in OT, but other types of uveitis. Atypical features and atypical location of the lesion regarding the retinal choroidal structures found in our study may facilitate better understanding of the clinical manifestations and pathogenesis of the disease.
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