Abstract
Purpose: :
To characterize the active retinochoroiditis lesion observed in patients with the classic clinical presentation of ocular toxoplasmosis (OT) utilizing spectral optical coherence tomography (SOCT).
Methods: :
Twenty-four patients with OT based on the classical clinical findings of an active focus of retinochoroiditis adjacent to a pigmented chorioretinal scar and positive serum toxoplasmosis IgG titers were included. Each patient underwent standardized ophthalmologic examination and multimodal fundus imaging, including SOCT evaluation.
Results: :
The mean age of the fourteen (58.3%) women and ten (41.7%) men was 27.6 ± 12.4 years. The mean ETDRS best-corrected visual acuity was 20/80-1. On SOCT evaluation, the posterior hyaloid was thickened in 95.8%. Increased hyper-reflective signals in the vitreous were observed in 75.0%. Vitreal spherical hyper-reflective depositions were observed in 50.0%. In all patients, at the active OT lesion site, the inner retinal layers were abnormally hyper-reflective with full-thickness disorganization of the retinal reflective layers (smudge effect) and some degree of choriocapillaris/choroidal optical shadowing. The retina was thickened at the active lesion site in 87.5%. The RPE-Bruch membrane reflective complex was focally increased or contained focal splits in 66.7%. Disorganization of the outer retinal highly reflective layers adjacent to the active OT lesion was observed in all patients.
Conclusions: :
The active OT lesion affected the inner retina with full-thickness disorganization of the retinal layers and some degree of choriocapillaris/choroidal optical shadowing in all patients. Adjacent to the lesion, the outer retina was consistently altered and the posterior hyaloid was thickened in all but one patient.
Keywords: uvea • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • chorioretinitis