Increased Submacular Choroidal Thickness in Active, Isolated, Extramacular Toxoplasmosis

Abstract

Toxoplasmic retinochoroiditis is a clinical diagnosis which may be supported by positive serum immunoglobulin (Ig)M and/or IgG titers. Classically, it is manifested by necrotizing retinitis with secondary involvement of the choroid and vitreous. 1 New imaging modalities have aided in the diagnosis and management of intraocular inflammatory diseases. Optical coherence tomography (OCT) allows for micron-level resolution of the retinal and choroidal anatomy. Recent published OCT studies have described structural changes in the vitreous, retina, and choroid at the site of active toxoplasmosis lesions. 2 The purpose of this study was to determine whether the submacular choroidal thickness is also affected in cases of active cases of isolated, extramacular toxoplasmic lesions.The study protocol followed the Tenets of the Declaration of Helsinki and was approved by the local institutional review board. Written informed consent was obtained. Eyes with a history of vitreoretinal surgery, laser photocoagulation, intravitreal injections, refractive error exceeding AE4 diopters, or other retinovascular abnormalities were excluded.All patients completed a full ophthalmic evaluation including a dilated examination and imaging at each visit. All patients were

Vascular hypoperfusion in acute optic neuritis is a potentially new neurovascular model for demyelinating diseases

“…The result obtained differs from the results expected based on the previous concept that the choroid tends to thicken in ocular inflammatory diseases, such as uveitis and CSCR. [ 37 , 63 – 65 ] On the other hand, the result obtained looks similar to the cerebral hypoperfusion that has been reported to occur in MS. Some recent studies found that impairment in functional cerebrovascular pathophysiology may be the underlying cause of neurodegeneration in MS and that the impairment may be mediated by endothelin-1 (ET-1).…”

“…[ 39 , 41 , 60 – 61 ] Hemodynamics can be further modified by the local environment (for example, uveitis) and local treatment (for example, an intravitreal injection of anti-VEGF agents). [ 62 – 65 ] For this reason, we set very strict criteria to exclude major systemic and ocular diseases that may disturb hemodynamics and excluded patients with high myopia or large anisometropia. Furthermore, to eliminate the effects caused by the compromise of circulation secondary to neuronal degeneration, we excluded all patients with any previous pathology in the retina, optic nerve, and intracranial visual pathway.…”

Morphological characteristics of ocular toxoplasmosis and its regression pattern on swept-source optical coherence tomography angiography: a case report

“…A histopathology study of acute VKH disease revealed that thickening of the choroid was due to diffuse infiltration of lymphocytes, macrophages, and epithelioid cells [20]. More recently, a study demonstrated that changes in submacular choroidal thickness occur even when the active retinochoroidal toxoplasmic lesion lies outside the macula [21]. The changes observed in the present study support the observations of previous studies in that the inflammation caused by ocular toxoplasmosis affects not only the active lesion but also wide areas of choroidal structures.…”

Parasitic Eye Disease in India and the World- A Major Review

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