Abstract
Purpose :
Optical Coherence Tomography can be a useful aid in identifying the clinical characterisitics of infective necrotising retinitis. The aim of this study is to describe the utility of posterior hyaloid adhesions (PHA) as an Optical Coherence Tomography biomarker of active Toxoplasma retinochoroiditis
Methods :
Retrospective review of OCT scans of all patients of infective retinitis presenting to the Uveitis services from January 2016 to September 2022. All the images were evaluated for the presence of PHA at the time of presentation
Results :
705 eyes with a diagnosis of any infective retinitis were initially analysed. This included 402 eyes with a diagnosis of toxoplasma retinitis and 303 eyes with a diagnosis of retinitis of any other etiology. Other etiologies included included syphilitic chorioretinitis, CMV retinitis, Neuroretinitis, Post Fever retinitis, ,endogenous endophthalmitis and Tubercular Retinitis. Cases without an OCT scan at the time of initial presentation, scans with signal strength of OCT less than 7 and poor media were excluded.
97 eyes of active toxoplasma retinochoroidits had an OCT scan of good quality and were included in the study. Similarly, 125 eyes of retinitis of other etiologies had a good quality scan and were included as a control group.
The OCT feature of posterior hyaloid adhesion (PHA) was present in 70 eyes (72 percent) in the toxoplasmosis group as compared to other retinitis where it was present in 32 eyes (26 percent). Univariate analysisis revealed Posterior Hyaloid adhesion was significantly more in toxoplasma retinochoroiditis compared to other retinitis. Multivariate analysis when adjusted for age and sex, the odds ratio of finding PHA was 5.22 in patients with Toxoplasma retinochoroiditis as compared to other retinitis. (p<0.001)
Conclusions :
OCT features can help in the diagnosis of toxoplasma retinochoroiditis. Posterior hyaloid adhesion to the toxoplasma lesion can be used a specific diagnostic OCT biomarker and can help in identifying and diagnosing active toxoplasma retinochoroiditis
This abstract was presented at the 2024 ARVO Imaging in the Eye Conference, held in Seattle, WA, May 4, 2024.