Evaluation of Cystoid Change Phenotypes in Ocular Toxoplasmosis Using Optical Coherence Tomography

Abstract

PurposeTo present unique cystoid changes occurring in patients with ocular toxoplasmosis observed in spectral domain optical coherence tomography (OCT).MethodsForty-six patients (80 eyes) with a diagnosis of ocular toxoplasmosis, who underwent volume OCT examination between January 2005 and October 2012, were retrospectively collected. Review of clinical examination findings, fundus photographs, fluorescein angiograms (FA) and OCT image sets obtained at initial visits and follow-up. Qualitative and quantitative analyses of cystoid space phenotypes visualized using OCT.ResultsOf the 80 eyes included, 17 eyes (15 patients) demonstrated cystoid changes in the macula on OCT. Six eyes (7.5%) had cystoid macular edema (CME), 2 eyes (2.5%) had huge outer retinal cystoid space (HORC), 12 eyes (15%) had cystoid degeneration and additional 3 eyes (3.75%) had outer retinal tubulation due to age related macular degeneration. In one eye with HORC, the lesion was seen in the photoreceptor outer segment, accompanied by photoreceptor elongation and splitting. Three eyes presented with paravascular cystoid degeneration in the inner retina without other macular OCT abnormality.ConclusionsIn this study, different phenotypes of cystoid spaces seen in eyes with ocular toxoplasmosis using spectral domain OCT (SD-OCT) were demonstrated. CME presented as an uncommon feature, consistently with previous findings. Identification of rare morphological cystoid features (HORC with/without photoreceptor enlongation or splitting) on clinical examination had provided evidence to previous experimental models, which may also expand the clinical spectrum of the disease. Cystoid degeneration in the inner retina next to the retinal vessels in otherwise “normal” looking macula was observed, which may suggest more often clinical evaluation for those patients. Further studies are needed to verify the relevance of cystoid features seen on SD-OCT in assisting with the diagnosis and management of ocular toxoplasmosis.

Comparing optical coherence tomography findings in different aetiologies of infectious necrotising retinitis

“…Cystic spaces within the retina were previously described in a large cohort of patients with intraocular toxoplasmosis. In this study, cystoid degeneration was identified in 15% of the patients and cystoid macular oedema (CME) in 7.5% 10. Our study confirms that cystoid degeneration is common in toxoplasmic retinochoroiditis, but a similar percentage of patients with viral retinitis had lacunae in the ONL.…”

Subretinal Fluid in Eyes with Active Ocular Toxoplasmosis Observed Using Spectral Domain Optical Coherence Tomography

“…These parameters can be more reliable than the visual acuity in assessing response to intervention [ 11 ] . Widespread availability of spectral domain OCT (SD-OCT) has provided improved visualization of the details of the neurosensory retina and has facilitated the detection of many retinal/choroidal abnormalities, including cystoid lesions in OT and SRF [ 10 , 12 , 13 ] . The purpose of the current study is to report the observation of SRF in patients with active OT, and to investigate its associate clinical course and therapeutic consequences.…”

Visual function and macular architecture in patients with inactive zone 2 and 3 toxoplasmic retinochoroiditis

“…In a retrospective study of 926 patients with active ocular toxoplasmosis, 49 (5.0%) patients presented optic disc swelling, and this was most frequently found in association with an active distant focus of retinochoroiditis (11) . Macular serous retinal detachment and cystoid changes have also been described in patients with toxoplasmic retinochoroiditis not involving zone 1 (16,17) . Vitreous inflammation secondary to retinochoroiditis can also induce vitreous haze and di sorders of the vitreoretinal interface.…”