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M. Khairallah, B. Jelliti, M. Ould El Hassen, A. Bettaieb, N. Boubaker, S. Zaouali, S. Ben Yahia; Acute Choroidal Ischemia Associated With Toxoplasmic Retinochoroiditis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5141.
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To report the association of acute choroidal ischemia with active toxoplasmic retinochoroiditis (RC).
The authors retrospectively reviewed the clinical records of 23 consecutive patients with acute toxoplasmic RC. All patients underwent a detailed ophthalmic examination at presentation and throughout follow-up, including dilated biomicroscopic fundus examination, fundus photography, fluorescein angiography, and indocyanine green (ICG) angiography.
Of 23 patients, eight (34.8%) had an area of retinal whitening around the focus of RC and typical choroidal perfusion defects on both fluorescein and ICG angiography. Associated findings in these eight patients include old retinochoroidal scars (7; 87.5%), serous retinal detachment (3; 37.5%), retinal hemorrhages (1; 12.5%), and multiple satellite dark dots on ICG angiography (6; 75%). All the findings seen at the acute stage resolved, with reperfusion of the sick choriocapillaris, in two to six weeks. Retinal pigment epithelium changes surrounding a toxoplasmic atrophic scar became apparent as features of choroidal ischemia disappeared and was associated with decreased final visual acuity in two patients (25%).
Acute choroidal ischemia appears to be a common complication of active toxoplasmic RC. Clinicians should be aware of this association and its potential anatomic and functional consequences. Fluorescein and ICG angiography should be performed in patients with ocular toxoplasmosis suspected of having acute choroidal ischemia to establish the definitive diagnosis.
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