Abstract
Purpose To highlight the advantages of optical coherence tomography angiography (OCTA) in delineating the morphological features of the retinal and choroidal vascular network during acute, relapsing, and quiescent stages of macular toxoplasma retinochoroiditis. Methods This prospective study included patients presenting with both active and quiescent ocular toxoplasmoses. OCTA was obtained to diagnose and follow the subsequent vascular network changes at diagnosis and six months after acute presentation. Results Twenty-three eyes of 23 patients were included. In active lesions, OCTA showed extensive, well-delineated areas of intense hyposignal and perifoveal capillary arcade disruption in the parafoveal superficial capillary plexus (pSCP) and less extensive hyposignal in the parafoveal deep capillary plexus (pDCP). Signals of decreased deep capillary density and disorganization were also seen in the choroid. In nonactive lesions, OCTA demonstrated a homogenous and equally attenuated grayish hyposignal of the pSCP and pDCP and a partial restoration of the nonperfused choroidal areas. Conclusion OCTA is a useful technique for vascular network analysis in toxoplasma retinochoroiditis. It allows the visualization of the different network changes and behaviors during the different stages of the infection.
Highlights
Toxoplasma gondii is a ubiquitous obligate intracellular parasite, which infects all warm-blooded vertebrates including humans as a zoonotic pathogen widespread in nature [1, 2]
The classical clinical feature of ocular toxoplasmosis includes an exuberant vitritis with an area of active focal chorioretinitis
Diagnoses were based on clinical characteristics consistent with macular toxoplasma retinochoroiditis, in the absence of other identifiable causes
Summary
Toxoplasma gondii is a ubiquitous obligate intracellular parasite, which infects all warm-blooded vertebrates including humans as a zoonotic pathogen widespread in nature [1, 2]. Toxoplasma retinochoroiditis is a common form of “infectious” posterior uveitis. It accounts for 30 to 55% of posterior uveitis and is a leading cause of visual impairment [6, 7]. The classical clinical feature of ocular toxoplasmosis includes an exuberant vitritis with an area of active focal chorioretinitis. Optical coherence tomography angiography (OCTA) is a noninvasive diagnostic tool which allows visualization of retinal and choroidal structure using motion contrast. Its indications in patient care are under continued clinical investigation, OCTA has shown promising
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