Toxoplasmosis Related Neuroretinitis: More than Meets the Eye

ABSTRACT

Background

The intracellular protozoan Toxoplasma (T. gondii) is a parasitic infection, normally asymptomatic in immunocompetent patients. It often manifests ophthalmically, with focal necrotizing retinitis, and is more rarely associated with vitritis and anterior uveitis. Neuroretinitis, which results in severe, painless visual loss, optic disc edema, and a macular star, is an unusual first presentation of toxoplasmosis which despite being rare, when it does occur tends to affect young, immunosuppressed patients.

Case presentation

This case report describes a 34-year-old, white, European, immunocompetent female, who developed sudden visual loss and was found to have optic disc edema and stellate macular exudates. She was managed in an ophthalmic unit in the UK, a country with a low prevalence of toxoplasmosis Following extensive investigation, confirming Toxoplasma the standard anti-toxoplasmosis treatment was commenced, resulting in visual improvement over the following 6 months.

Conclusion

Toxoplasmic neuroretinitis should be considered with no background of systemic illness and in the absence of classical risk factors.

KEYWORDS:

• Immunocompetent
• macular star
• neuroretinitis
• stellate macular exudates
• Toxoplasma gondii
• toxoplasmosis

Acknowledgments

We would like to thank the patient discussed in this case for allowing us to publish her journey and to James Cook University Hospital for their support in creating this manuscript.

Consent

Written consent was obtained from the patient from the inclusion of material pertaining to themselves that they acknowledge that they cannot be identified via the article; and that they have been fully anonymized.

Disclosure Statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

This work was not supported by grants or funding agencies.