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Thomas Ness, Sonja Heinzelmann, Michael Reich, Charlotte Evers; Choroidal neovascularisation secondary to ocular toxoplasmosis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4176.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the frequency, optical coherence tomography (OCT) and fluorescein angiography (FA) features and demographics in patients with choroidal neovacularisation (CNV) secondary to ocular toxoplasmosis.
We analyzed retrospectively the clinical charts of all patients with ocular toxoplasmosis examined at the Eye Center, University of Freiburg between 1997 and 2017. Diagnosis was based on typical clinical features (focal retinitis, hyperpigmented retinochoroidal scar) and in some cases confirmed by serology or PCR from intraocular fluids. Demographic data, localization of toxoplasmic lesion, frequency of choroidal neovascularisation, diagnostics and therapy were evaluated.
In the study 142 patients (169 eyes) with ocular toxoplasmosis were included. The mean age at initial diagnosis was 26 years. About 20% suffered from bilateral disease. Lesions were peripapillary in 14%, central in 46% and peripheral in 49%.We identified 13 patients with CNV among all patients with ocular toxoplasmosis, representing 17% of the patients with central lesion. The mean age of these patients was 27 years. In 2 patients CNV was peripapillar, all remaining patients suffered from macular CNV. More CNV patients were male (54% vs 43%). All eyes with active CNV (12/15) were treated successfully with monoclonal antibodies to vascular endothelial growth factor (VEGF) (2-54 intravitreal injections). During follow-up, in 5 of the 13 CNV patients both either active CNV or relapse of the inflammation took place. OCT as well as FA were usefull tools to differentiate CNV from relapse of retinochoroiditis.
CNV in ocular toxoplasmosis is a frequent complication. Differentiation between relapse of inflammation or CNV is possible with OCT and FA. Treatment with anti-VEGF is a therapeutic option in CNV secondary to ocular toxoplasmosis.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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