Vitrectomy for ocular toxoplasmosis: a case report and literature review

Ocular toxoplasmosis (OT) is a parasitic ocular disorder triggered by Toxoplasma gondii infection, ranking as a leading cause of posterior uveitis. This pathogen spreads globally, with nearly one-third of the world's population having previous infection evidence, and OT may cause irreversible severe visual loss; its typical fundus features include vitreous opacities and focal yellowish-white inflammatory chorioretinal lesions, while active lesions often emerge beside old pigmented chorioretinal scars, and lesions involving the macula or optic disc usually lead to poor visual outcomes. Human immune function changes with age: it is immature in infancy, matures in young adulthood, and declines in the elderly via immunosenescence, which weakens innate and adaptive immunity, induces chronic low-grade inflammation, and raises infection risk. OT diagnosis mainly relies on typical fundus manifestations, while atypical cases require combined serological detection, Goldmann-Witmer coefficient detection and intraocular fluid PCR tests. The classic triple therapy carries obvious adverse reactions damaging bone marrow, liver and kidneys, so trimethoprim-sulfamethoxazole serves as a common alternative anti-parasite drug, with corticosteroids added as needed to suppress inflammation. For severe complications such as dense vitreous opacification, retinal detachment, retinal breaks and vitreous hemorrhage, pars plana vitrectomy combined with intraoperative laser photocoagulation is the primary surgical option. This paper reports an immunocompetent elderly OT patient who achieved a favorable prognosis after combined surgical intervention and postoperative anti-Toxoplasma medication, and further summarizes the core diagnostic essentials of OT as well as the clinical indications and value of vitrectomy.