Evaluation of perfusion changes during active ocular toxoplasmosis
Purpose
To report perfusion changes during active recurrent toxoplasmic retinochoroiditis by optical coherence tomography angiography (OCTA) as a non-invasive imaging modality that has not been widely used in cases of ocular toxoplasmosis.
Methods
A case report. Complete history taking, comprehensive ophthalmological examination, serological titer, IgG avidity testing, and serial OCTA (6x6 mm) was performed.
Results
A 22-year-old woman came to the outpatient clinic complaining of blurred vision along with floaters in her left eye for the previous month. The right eye's visual acuity (VA) was 6/6, and the left eye was 4m CF. The anterior segment examination of both eyes was unremarkable. There was 3+ vitreous cells (VC) in the left eye. Funduscopic examination showed moderate vitritis, a focal yellowish lesion adjacent to the retinochoroidal scar over the macula, and segmental arteriolitis in the superotemporal, inferotemporal, and inferonasal areas. She has positive IgM and IgG anti-Toxoplasma antibodies, with a strong IgG avidity, indicating chronic infection. The OCTA examination revealed decreased perfusion marked by hypointense areas in accordance with the area of retinitis, that more distinct in the superficial retinal layer. The patient was treated with oral Cotrimoxazole (80 mg trimethoprim and 400 mg sulfamethoxazole) 2 tablets twice daily, followed by a tapered dosage of oral prednisone 40 mg daily. At 6-weeks follow-up, the vitritis was subsided, the active lesion had begun to heal, and the arteriolitis in the inferonasal and inferotemporal areas had resolved. The OCTA findings showed improved perfusion particularly in the superficial layer.
Conclusion
The OCTA describes microvascular changes in the retinal and choroidal layers, so it is helpful to evaluate clinical improvement and treatment efficacy in ocular toxoplasmosis.
Conflict of interest
No
Authors 1
Last name
SOFIA
Initials of first name(s)
O
Country
Indonesia
Authors 2
Last name
PRAYITNANINGSIH
Initials of first name(s)
S
Country
Indonesia
Authors 3
Last name
SUSIANTI
Initials of first name(s)
H
Country
Indonesia
Authors 4
Last name
FITRI
Initials of first name(s)
LE
Country
Indonesia
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