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Related Experiment Videos

[Segmental retinal arteritis and retinochorioiditis].

M Tetz1, F G Holz, G Gallasch

  • 1Universitäts-Augenklinik Heidelberg.

Der Ophthalmologe : Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft
|February 1, 1992
PubMed
Summary

This case study highlights a rare instance of acute ocular toxoplasmosis with retinal vasculitis in a patient with a history of tuberculosis. Combined treatment effectively reduced inflammation, suggesting a complex immunological cause.

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Area of Science:

  • Ophthalmology
  • Immunology
  • Infectious Diseases

Background:

  • Acute ocular toxoplasmosis typically presents as a focal retinochoroidal infiltrate near an old scar.
  • Atypical presentations include retinal granulomas, neovascularization, gliosis, and detachment.
  • Rarely, ocular toxoplasmosis involves vasculitis and perivasculitis.

Observation:

  • A 28-year-old male with congenital toxoplasmosis (intracerebral calcifications, hydrocephalus) presented with acute retinochoroidal infiltrate and segmental retinal periarteritis.
  • The patient had a history of pulmonary tuberculosis treated 6 years prior.
  • Fluorescein angiography showed irregularities in affected arterioles, with no venule inflammation.

Findings:

  • The co-occurrence of acute toxoplasmosis and prior tuberculosis suggests a complex immunological etiology for the retinal vasculitis.

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  • Segmental periarteritis without periphlebitis is an exceptionally rare finding.
  • Systemic treatment with pyrimethamine, trimethoprim, sulfamethoxazole, and prednisolone led to reduced retinochoroidal inflammation and periarterial infiltrates.

    • Implications:

    • This case underscores the potential for complex immunological interactions in ocular inflammatory diseases.
    • Understanding these interactions is crucial for diagnosing and managing rare presentations of ocular toxoplasmosis.
    • The successful treatment highlights the efficacy of a combined therapeutic approach in managing such complex cases.