Abstract
A retrospective analysis of eight eyes of six patients affected by atypical chorioretinitis was performed, analyzing the clinical presentation and treatment.
Introduction
Atypical chorioretinitis due to toxoplasmosis manifests as extensive areas of chorioretinitis without adjacent pigmented lesions.
Methods
Age, sex, bilaterality, primary lesion location, treatment received, healing time after established treatment, existence of a subsequent recurrence, and immunosuppression data are described.
Results
The presentation of chorioretinitis was widely distributed: Peripapillary 20%, optic papilla 12.5%, papillomacular beam 12.5%, macular lesion 12.5%, temporal arches 20%. Nevertheless, the most frequent presentation was as peripheral lesions in 50% of the cases. The average healing time was 131 days, with recurrence of the disease in two of the described cases. Moreover, two of the patients included in this study were immunocompromised (HIV positive) and in these two cases chorioretinitis occurred bilaterally.
Figure. 1
- A 29-year-old female with debut of peripapillary chorioretinitis injury with associated periflebitis and mild vitritis.
- Retinography of the patient after treatment with clindamycin, pyrimethamine and oral corticosteroids.
Figure.2
- A 49-year-old male, HIV positive, presenting papillary involvement with neuroretinitis in RE.
- Retinography eight months later showing residual papillary involvement with residual retinovitreal fibrosis and secondary optic atrophy
Conclusion
Chorioretinitis due to toxoplasma with atypical presentation usually occurs in patients below 50 years of age. Moreover, in this study patients who presented bilaterally presentation of the disease were immunocompromised individuals.
Figure. 3
- Retinography of a 17-year-old woman with primary involvement of toxoplasmosis affecting the upper perimacular area and upper papillomacular bundle.
- Retinography after inactivation of the chorioretinal lesion after treatment with sulphadiazine, pyrimethamine and prednisone at six months.
Figure .4
- Retinography of an 18-year-old male patient with primary involvement in a macular area with associated vitritis. Treatment with cotrimoxazole and prednisone was prescribed.
- Extensive inactive macular chorioretinal lesion with residual papillary fibrosis three months later.
Figure. 5
- A 39-year-old woman with large inactive peripheral chorioretinal lesion and large residual vitreous fibrosis due to the existing large preexisting activity.
- Retinography of a 44-year-old HIV-positive male, who performs bilaterally, in RE, peripheral chorioretinal lesions are visualized, and another that affects the lower peripapillary level inactive after treatment with pyrimethamine, sulfadiazine and prednisone.
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