Main Article Content
Background: Ocular toxoplasmosis is one of the commonest causes of posterior uveitis worldwide. Its diagnosis can be challenging as it can present with a wide range of clinical signs. This study describes the clinical manifestations, management and outcome of atypical ocular toxoplasmosis seen in different age groups of patients.
Case Series: There were three patients in this series. The first case was a 10-year-old child with 1-week history of left eye blurring of vision and seeing a black spot. The second case was a 44-year-old lady who presented with left eye image distortion and floaters for 3 weeks duration while the third case was a 63-year-old lady who presented with left eye blurring of vision for 1-week duration. All patients presented with retinochoroiditis and vasculitis. The first case also had mutton-fat keratic precipitates, iris nodule, anterior chamber inflammation, peripapillary hemorrhage and minimal vitreous haemorrhage. The second case had a retinal scar and the third case had mutton-fat keratic precipitates, anterior chamber inflammation and iris plug. All patinets had positive serology for Toxoplsmosis and were treated with oral trimethoprim/sulfamethoxazole, oral prednisolone and topical steroid.
Conclusion: Clinicians may face a challenge when diagnosing atypical ocular toxoplasmosis. Understanding the various manifestations of ocular toxoplasmosis that may occur in the different age groups of patients may help in diagnosing and managing the disease.
Conflict of interest: The authors report no conflict of interest.
2. Holland, G.N. (2009). Ocular toxoplasmosis: the influence of patient age. Mem Inst Oswaldo Cruz, 104(2): 351-7.
3. Wilder, H.C. (1952). Toxoplasma chorioretinitis in adults. AMA Arch Ophthalmol, 48(2): 127-36.
4. Jasper, S., Vedula, S.S., John S.S, Horo, S., Sepah, Y.J., Nguyen, Q.D. (2013). Corticosteroids as adjuvant therapy for ocular toxoplasmosis. Cochrane Database Syst Rev. 2013; (4):CD007417.
5. Park, Y.H., Nam, H.W. (2013). Clinical features and treatment of ocular toxoplasmosis. Korean J Parasitol. 51(4): 393-9.
6. Graff, J.M., Russell, S.R. (2007) Acquired Ocular Toxoplasmosis: 42-year-old female with “fuzzy” vision for two weeks. EyeRounds.org. Available from: https://www.EyeRounds.org/cases/74-Acquired-Toxoplasmosis-Retina.htm. Published September 14, 2007.
7. Kianersi, F., Naderi Beni, A., Naderi Beni, Z. (2012) Clinical manifestation and prognosis of active ocular toxoplasmosis in Iran. Int Ophthalmol. 32(6): 539-45.
8. Bosch-driessen, L.E., Berendschot, T.T., Ongkosuwito, J.V., Rothova, A. Ocular toxoplasmosis: clinical features and prognosis of 154 patients. Ophthalmology. 109(5): 869-78.
9. Johnson, M.W., Greven, G.M., Jaffe, G.J., Sudhalkar, H., Vine, A.K. Atypical, severe toxoplasmic retinochoroiditis in elderly patients. Ophthalmology. 104(1): 48-57.
10. Holland, G.N. (2004) Ocular toxoplasmosis: a global reassessment. Part II: disease manifestations and management. Am J Ophthalmol. 137(1): 1-17.
11. Dodds, E.M., Holland, G.N., Stanford, M.R., Yu, F., Siu, W.O., Shah, K.H., Ten Dam-van Loon, N., Muccioli, C. Hovakimyan, A., Barisani-Asenbauer T., International Ocular Toxoplasmosis Research Group. (2008) Intraocular inflammation associated with ocular toxoplasmosis: relationships at initial examination. Am J Ophthalmol. 146(6): 856-65.e2.