Ocular Toxoplasmosis: A Case Report

Abstract

Report a case of a male patient with a macular scar compatible with ocular toxoplasmosis (OT) in right eye (RE) and review the relevant literature on this disease. A patient, who attended for a routine contact lens follow up, presented with amblyopic exotropia without any ocular disease. Best-corrected visual acuity of the affected eye was 20/40 with constant and mono-fixation exotropia. Ophthalmoscopic assessment revealed a macular scar compatible with OT. OT is the leading cause of infection in the posterior segment. Inactive cases could be asymptomatic and diagnosis requires a complete eye examination, providing a correct diagnosis and patient management.

Challenges of Ocular Toxoplasmosis Treatment in Multiple Drug Intolerance Syndrome: A Case Report and Literature Review

“…A recurring episode is possible, particularly if the patient's immune system is impaired. Some studies have reported the incidence of recurrences being common between the first and third decade of life (16)(17)(18)(19). The findings in this case are consistent with these aforementioned studies (16)(17)(18)(19), as the patient, who was also in her third decade of life, presented with a chorioretinal scar and adjacent retinitis suggesting the recurrence of active disease.…”

“…Some studies have reported the incidence of recurrences being common between the first and third decade of life (16)(17)(18)(19). The findings in this case are consistent with these aforementioned studies (16)(17)(18)(19), as the patient, who was also in her third decade of life, presented with a chorioretinal scar and adjacent retinitis suggesting the recurrence of active disease. This is also supported by the serology of raised IgG titres but with normal IgM titres, which suggests a previous infection rather than a recent infection.…”

“…The lesions are commonly seen in the macular area, as seen in this case, probably resulting from the entrapment of free parasites in capillary peri-foveal retinal terminals (15,16). Subsequently, a well-defined hyperpigmented chorioretinal scar appears (16)(17)(18). A recurring episode is possible, particularly if the patient's immune system is impaired.…”

“…Ocular toxoplasmosis can present in one of the three phases, i.e., the active phase, chronic phase or recurrent phase (15,16). Chorioretinitis manifests as a circular yellowish-white lesion with elevated, fuzzy margins and surrounding retinal oedema during the active phase (15,17). The lesions are commonly seen in the macular area, as seen in this case, probably resulting from the entrapment of free parasites in capillary peri-foveal retinal terminals (15,16).…”

The One Health Approach to Toxoplasmosis: Epidemiology, Control, and Prevention Strategies

“…When women acquire the infection more than 6 months prior to gestation, risk of transmission to the fetus is considerably reduced. Although preventable and treatable, congenital, ocular, and postnatal T. gondii infection is not curable and persists in all infected persons (Ortiz et al 2013; Peyron et al 2016; Ngo et al 2017). Latent or primary toxoplasmosis can be particularly dangerous in individuals with compromised immune systems, including those treated with corticosteroids, cytotoxic medicines, and antibody to tumor necrosis factor alpha (Lykins et al 2016; Wang et al 2017).…”