Bilateral Chorioretinal Scars in a Child - Case Report

The eye manifestations of intrauterine infections are multiple, but chorioretinal scars and/or active chorioretinitis are the most frequently reported. When associated with other systemic manifestations of the infection, the diagnosis becomes more obvious, but when eye involvement is the only abnormality, etiology often remains uncertain. We are presenting the case of an 8-year-old female patient whose fundus lesions revealed an unusual choroidoretinopathy, associated with cataract in one eye. Her general examination and her medical history were unremarkable. Blood test for multiple pathogenic agents (HIV, hepatitis Band C, Toxoplasma, Toxocara, Borrelia, CMV, Epstein-Barr virus) were negative. Complete blood count, ESR, fibrinogen and CRP are all within normal limits. Plasma ornithine levels were in normal range (ruling out a diagnosis of gyrate atrophy). The chorioretinal lesions discovered in this 8 years old child may be caused by an acquired or a congenital infection. As in most similar cases, the clinical aspect, the medical history and the blood work did not help too much in establishing the moment of the infection or the causative agent. A complete clinical, structural and functional base-line evaluation is however mandatory when facing such a case. Periodic follow-up is recommended in order to assess the evolution of the disease.