Rhegmatogenous Retinal Detachment in Ocular Toxoplasmosis: A Case Series

Toxoplasma gondii causes ocular toxoplasmosis (OT) with potential retinal complications like rhegmatogenous retinal detachment (RRD), and retinal breaks (RB). While various management strategies exist, there is no universally accepted standard of care, and the most common combination procedure is scleral buckle (SB), pars plana vitrectomy (PPV), and silicone oil. The purpose of this case series is to evaluate and discuss the risk factors, phenotypes, management, and outcomes of rhegmatogenous RRD in six eyes (five patients) with OT from retrospective chart review. The age range was broad (27-77 years old), with four patients over the age of 50. RRDs were caused by one retinal tear per eye in two out of five eyes (40%), and ≥2 tears in three out of five eyes (60%). No retinal tears were detected in one eye. We reported 77% of superior retinal tears, and the incidence of macula-off RRD was 66% (four out of six eyes). Three eyes underwent PPV with gas tamponade, and two eyes underwent SB with PPV and gas. One patient declined surgery. The five eyes affected with RRD that underwent surgery had a retinal re-attachment after one surgery (100%) with a mean follow-up of 26 months. Four out of five eyes had visual improvement, and one eye lost one line of vision (20/200 to 20/400). An age older than 50 years and CT or inactive acquired OT appear to be risk factors for RRD. Depending on the location of retinal tears, particularly inferior, or the chronicity of RRD, an SB can be useful to add to PPV.