Presumed acquired ocular toxoplasmosis
M. J. Ronday, L. Luyendijk, G. S. Baarsma, J. G. Bollemeijer, A. Van der Lelij and A. Rothova
Netherlands Ophthalmic Research Institute, Amsterdam.
OBJECTIVE: To describe the clinical characteristics and laboratory findings
of eight patients with focal chorioretinitis presumably caused by acquired
toxoplasmosis. DESIGN: Case series. SETTING: Referral hospitals in the
Netherlands. PATIENTS: Eight patients, aged 42 to 75 years, with unilateral
focal chorioretinitis and laboratory evidence of a recently acquired
infection with Toxoplasma gondii. MAIN OUTCOME MEASURES: Findings from
ocular examination and analysis of both serum and aqueous humor samples for
Toxoplasma and viral antibodies. RESULTS: All patients had unilateral focal
chorioretinitis without associated old scars in the posterior pole.
Patients treated with systemic or periocular corticosteroids not
accompanied by antiparasitic medication showed a rapid increase of
inflammation. All eight patients had Toxoplasma IgM antibodies in their
serum samples, seven of whom had high Toxoplasma IgG titers. Five of eight
patients had increased intraocular production of IgG antibodies against T
gondii. CONCLUSION: Unilateral focal chorioretinitis in patients of any age
should alert the clinician to consider acquired ocular toxoplasmosis in the
differential diagnosis.
