Evaluation of spectral domain and time domain optical coherence tomography findings in toxoplasmic retinochoroiditis

Abstract

Purpose:To investigate spectral domain optical coherence tomography (SD-OCT) findings and compare them with time domain (TD)-OCT imaging of macula and retinochoroiditis lesions of patients with toxoplasmosis.Design:Prospective cross-sectional study.Methods:Ten eyes of 10 patients with active toxoplasmic retinochoroiditis were included. Morphologic features from the macula and retinochoroiditis lesions were obtained at baseline and at 6-week follow up. Scan acquisition protocols for TD-OCT included raster and radial lines through the retinochoroiditis lesion, fast macular, and a linear scan from the lesion to the fovea, whereas the acquisition protocols for SD-OCT also included horizontal volume scans at the lesion site and at the macula. Thickness measurements obtained by SD-OCT were analyzed.Results:At baseline, macular serous retinal detachment was observed in five patients; two of them only seen by SD-OCT. Retinochoroidal lesions were 4260 μm distant from the fovea on average (R = 681–7130) and this distance had an indirect correlation to the presence of macular detachment. Epiretinal membrane and vitreo-macular traction were also observed. The posterior hyaloid was not identified in four patients by TD-OCT and only in one by SD-OCT at baseline. Perilesional subretinal fluid was observed in two patients. The median retinal thickness significantly decreased at the retinochoroiditis lesion (P = 0.0004), and all the patients remained with disorganized retinal layers reflectivity at follow up.Conclusion:SD-OCT is a useful tool in the diagnosis of macular changes related with toxoplasmic retinochoroiditis. SD-OCT is superior in evaluating retinal changes associated with ocular toxoplasmosis.

Optical coherence tomography imaging in uveitis

“…Increased retinal reflectivity and thickening of the lesion site [165,170,171] RPE -choriocapillaris/choroidal optical shadowing [165,170,171] Thickening of the posterior hyaloid, partial or complete posterior vitreous detachment over the retinochoroidal lesion [165,170,171] Multiple, small, granular hyperreflective spots on the vitreoretinal interface in the vicinity of the retinochoroidal lesion [166,168] Retinochoroidal scar…”

“…Decreased retinal thickness [165,171] Focal choriocapillaris/choroidal relative hyperreflectivity [165,171] Complete posterior vitreous detachment [165,171] Punctate outer retinal toxoplasmosis…”

“…Diniz et al [171] defined SD OCT features of the retinochoroidal lesion, macula and vitreous and compared them with TD OCT scans in patients with active ocular toxoplasmosis. Ten eyes of ten patients were analyzed.…”

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.…”

Causes of visual impairment in patients with ocular toxoplasmosis

“…Diniz et al reported macular serous retinal detachment as the most common macular abnormality, with a ratio of 50% in patients with active toxoplasma chorioretinitis, and reported that one of their patients showed presence of residual fluid at follow-up visits [6]. The investigators stated that this could be related to the proximity of the lesion to the macula.…”