Abstract
PurposeOcular toxoplasmosis is the most common cause of infectious uveitis worldwide. The diagnosis of ocular toxoplasmosis is primarily clinical when it is a typical presentation.With an atypical presentation in the fundus, parasitological diagnosis is a decisive contribution, as well as multimodal imaging. The aim of this study was to investigate vitreal, retinal, and choroidal morphologic changes in active and scarred toxoplasmosis lesions using swept source optical coherence tomography. To our knowledge, it is the first study in Tunisia which describes with precision the retinochoroidal lesions caused by Toxoplasma Gondi by means of the optical coherence tomography (OCT). MethodsA retrospective analysis of fifteen patients diagnosed with ocular toxoplasmosis was conducted. The patients were examined at ophthalmology service of Farhat Hached Hospital in Sousse Tunisia between January 2002 and December 2019. Complete ophthalmologic examination including best-corrected visual acuity, slit lamp biomicroscopy, dilated biomicroscopic and fundus examinations, colour fundus photography as well as fluorescein angiography and OCT were done at the initial visit and during follow-up. ResultIn the acute phase, thickening, hyper-reflectivity of the neurosensory retina, posterior shading, bumping of the RPE, hyporeflectivity and thickening of choroid were found in 86,6% of patients. During follow-up, neurosensory retinal layers thinning and disorganization, interrupting ofthe ellipsoid zone (EZ), and RPE hyper reflective were noticed in 73% of patients. The choroid became thin and more hyperreflective in 73% of patients. Multiple hyperreflective dots in the vitreous cavity and posterior hyaloid thickening were demonstrated in the acute phase in 60% of patients, with complete resolution and detachment of the posterior hyaloid in the scarred lesions. ConclusionThe SS-OCT is an important adjunctive imaging modality in the diagnosis and follow-up of patients with ocular toxoplasmosis.
Highlights
Ocular toxoplasmosis is the most common cause of infectious uveitis worldwide with a prevalence ranging from 3.8% to 17.7% [1]
The aim of our study was to investigate vitreal, retinal, and choroidal morphologic changes in active and scarred toxoplasmosis lesions using Swept-source optical coherence tomography (SS-OCT). It is the first study in Tunisia which describes with precision the retinochoroidal lesions caused by Toxoplasma Gondi by means of the optical coherence tomography (OCT).This manuscript is reported in ac-cordance with PROCESS guidelines [15]
Multiple hyperreflective dots in the vitreous cavity, compatible with vitritis, and posterior hyaloid thickening were demonstrated in the acute phase, with complete resolution and detachment of the posterior hyaloid in the scarred lesions
Summary
Ocular toxoplasmosis is the most common cause of infectious uveitis worldwide with a prevalence ranging from 3.8% to 17.7% [1]. The eye is the main target organ for symptomatic manifestations of the infection, which may be congenital or acquired [3]. It most often affects young people between the ages of 20 and 40 [4]. The diagnosis of ocular toxoplasmosis is primarily clinical when it is a typical presentation [5]. It is presumed when discovering an evocative lesion in the eye fundus. With an atypical presentation of ocular toxoplasmosis in the fundus, parasitological diagnosis is a decisive contribution, as well as multimodal imaging
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