Clinical Outcomes of Ocular Toxoplasmosis-Associated Rhegmatogenous and Tractional Retinal Detachment

Purpose: To investigate the incidence, characteristics, and outcomes of ocular toxoplasmosis-associated rhegmatogenous or tractional retinal detachment (RD). Methods: This was a single-center, interventional retrospective case series of consecutive patients diagnosed with ocular toxoplasmosis who subsequently developed rhegmatogenous RD (RRD) or tractional RD (TRD) between January 2013 and October 2022. Patients who were followed for at least 3 postoperative months were included. The location of the retinochoroidal scar, anatomy of the RD, surgical techniques used for repair, and anatomic and visual outcomes were analyzed. Results: Of 422 patients diagnosed with ocular toxoplasmosis, RRD or TRD developed in 36 patients (8.5%). Inclusion criteria were met in 20 eyes of 19 patients. The mean age at RD diagnosis was 47 years, and the mean follow-up was 3.6 years. Most ocular toxoplasmosis-associated RD were rhegmatogenous (75% [n = 15 eyes]), and half of the eyes had active retinochoroiditis at the time of presentation (50% [n = 10]). At final follow-up, median visual acuity (VA) had improved from counting fingers to about 20/80, and single-surgery anatomic success was achieved in 15 of 17 operated eyes (88%), with final reattachment achieved in 100% without silicone oil. Active retinochoroiditis at the time of RD diagnosis was associated with worse final VA after adjustment for confounding variables (P = .005). Conclusions: RRD or TRD occurred in 8.5% of patients with ocular toxoplasmosis. Surgery produces favorable anatomic results, but visual outcomes remain guarded, especially in eyes with active retinochoroiditis.