Management Dilemmas of Atypical Ocular Toxoplasmosis Aided by Wide-Field Fluorescein Angiography

Abstract

Purpose: To report an atypical presentation of ocular toxoplasmosis and to demonstrate the utility of wide-field angiography in delineating peripheral retinal pathology.

Methods: Case Report.

Results: A 17-year-old male presented with acute unilateral papillitis and retinochoroiditis. Laboratory testing supported reactivation of congenitally acquired Toxoplasma gondii infection. Wide-field fluorescein angiography showed extensive retinal vasculitis. The patient was treated with sulfamethoxazole/trimethoprim. Ocular inflammation resolved over a two-week period. There was no documented visual loss.

Conclusion: Wide-field fluorescein angiography details ocular pathology otherwise unnoticed on traditional posterior pole fluorescein angiography. Documentation of extensive vasculitis associated with ocular toxoplasmosis can assist with management decisions.

KEYWORDS::

• angiography
• fluorescein
• imaging
• ocular
• papillitis
• retinochoroiditis
• toxoplasma
• toxoplasmosis
• wide-field

ACKNOWLEDGMENT

Declaration of Interest: Dr. Friberg has received research funding from Optos and has served as a consultant.