Acquired ocular toxoplasmosis. A fluorescein angiography study

Area of Science:

• Ophthalmology
• Infectious Diseases
• Immunology

Background:

• Toxoplasmosis is a parasitic infection that can affect various organs, including the eyes.
• Ocular toxoplasmosis can manifest with diverse clinical presentations, potentially mimicking other retinal and choroidal vascular diseases.

Observation:

• A 31-year-old male presented with acute bilateral vision deterioration.
• Initial funduscopic examination revealed findings suggestive of central retinal vein occlusion (CRVO) in the right eye and disseminated choroiditis in the left eye.
• Serological testing showed a high titer (1:2048) for toxoplasmosis.

Findings:

• Fluorescein angiography demonstrated a unique pattern of isolated choroidal occlusions, contradicting the initial clinical diagnoses of CRVO and disseminated choroiditis.
• Treatment with antitoxoplasmotic therapy led to complete visual recovery in both eyes.
• A 14-year follow-up confirmed sustained visual acuity and absence of recurrence.

Implications:

• This case highlights the importance of considering toxoplasmosis in the differential diagnosis of various ocular vascular and inflammatory conditions.
• Prompt and specific antitoxoplasmotic treatment can effectively reverse vision loss caused by ocular toxoplasmosis.
• The findings underscore the potential for toxoplasmosis to present with atypical vascular occlusive phenomena in the choroid.