1/39. Upward extension of an atrophic tract of the retinal pigment epithelium associated with congenital macular toxoplasmosis.PURPOSE: To report an unusual case of gravitational atrophic tract of the retinal pigment epithelium in a 20-year old woman. methods: Case Report. RESULTS: The patient had macular cicatricial congenital toxoplasmic chorioretinitis in both eyes. In the right eye, an atrophic tract of the retinal pigment epithelium originating from the upper margin of the macular scar extended upwards toward the retinal periphery. CONCLUSION: The unusual upward direction of the atrophic tract of retinal pigment epithelium may be explained by the in utero head position during the active phase of the chorioretinal disease.- - - - - - - - - - ranking = 1keywords = retinitis (Clic here for more details about this article) |
2/39. Use of the polymerase chain reaction for diagnosis of ocular toxoplasmosis.OBJECTIVE: To report a cohort of patients in whom polymerase chain reaction (PCR) was performed on vitreous samples and to place in perspective the current role of PCR in the diagnosis of ocular toxoplasmosis. DESIGN: Noncomparative case series. PARTICIPANTS: Fifteen patients in whom toxoplasmic retinochoroiditis was considered in the differential diagnosis and in whom the clinical presentation was not diagnostic and/or response to treatment was inadequate. INTERVENTION: Examination of vitreous fluid by PCR and of serum for the presence of toxoplasma-specific antibodies. MAIN OUTCOME MEASURES: Presence of toxoplasma gondii dna, serologic test results, clinical findings, treatment, and outcome. RESULTS: In 7 of 15 patients, vitreous fluid examination results by PCR were positive for the presence of T. gondii dna. Five of these seven patients had serologic test results consistent with toxoplasma infection acquired in the distant past; the other two patients had serologic test results consistent with retinochoroiditis in the setting of acute toxoplasmosis. The PCR results influenced the management of these patients in six of the seven positive cases. In the eight patients in whom vitreous examination results were negative by PCR, either toxoplasma serology was negative (6), the retinal lesions were caused by cytomegalovirus (1), or, on further consideration, the eye signs were not consistent with those of toxoplasmic retinochoroiditis (1). CONCLUSION: In patients in whom toxoplasmosis is considered in the differential diagnosis but in whom the presentation is atypical, PCR was frequently a useful diagnostic aid.- - - - - - - - - - ranking = 0.031311783406353keywords = cytomegalovirus (Clic here for more details about this article) |
3/39. Acute iridocyclitis in a patient with AIDS diagnosed as toxoplasmosis by PCR.PURPOSE: To study the etiology of an acute iridocyclitis in a patient with AIDS using polymerase chain reaction (PCR) analysis of aqueous humor. methods: Case report describing a patient diagnosed with toxoplasmic retinochoroiditis in his left eye. He stopped his treatment after three weeks and subsequently developed an acute iridocyclitis without chorioretinitis in the fellow eye. anterior chamber paracentesis was performed and aqueous humor was assayed by PCR. RESULTS: PCR of the aqueous humor showed positivity for toxoplasma gondii. The iridocyclitis responded to topical dexamethasone and oral treatment with pyrimethamine and sulfadiazine. CONCLUSION: PCR is an effective method to diagnose toxoplasmic iridocyclitis in a patient with AIDS.- - - - - - - - - - ranking = 1keywords = retinitis (Clic here for more details about this article) |
4/39. lymphocytic choriomeningitis virus chorioretinitis mimicking ocular toxoplasmosis in two otherwise normal children.PURPOSE: To report unilateral macular lesions, mimicking toxoplasmic scars, in two children with serological evidence for lymphocytic choriomeningitis virus infection. methods: case reports. RESULTS: patients were 4 and 5 years old, with negative toxoplasma serologies and no sign of rubella, cytomegalovirus, or herpes simplex infection (TORCH evaluation). lymphocytic choriomeningitis virus infection was detected in both cases by enzyme-linked immunosorbent assay and confirmed by Western immunoblotting. The modes of infection were unknown; no history of symptomatic systemic lymphocytic choriomeningitis virus infection was reported, and lymphocytic choriomeningitis virus serologies were negative in the mothers of the patients. Neurological examinations and brain magnetic resonance imaging were normal. CONCLUSION: Our observations suggest that chorioretinal scars can be an isolated manifestation of lymphocytic choriomeningitis virus infection.- - - - - - - - - - ranking = 4.0313117834064keywords = retinitis, cytomegalovirus (Clic here for more details about this article) |
5/39. Ocular involvement in systemic toxoplasmosis: a case report.We report a case of adult acquired toxoplasmosis with ocular involvement in a 29 year old immunocompetent female. The patient had an illness for approximately 3 weeks characterized by lymphadenopathy, malaise and rash that was diagnosed serologically as toxoplasmosis. At the time of diagnosis, she developed signs and symptoms of retino choroiditis. She had serologic evidence of cytomegalovirus (CMV) infection as well as the recent toxoplasma infection. The patient was treated with pyrimethanime, sulfadiazone and folic acid for 6 weeks, plus prednisone for 4 weeks, during which the illness resolved. toxoplasmosis is a protozoan infection that occurs worldwide, and is the most common cause of infectious retinochoroiditis in otherwise healthy individuals. Most cases of toxoplasma infection in the immunocompetent adult are asymptomatic. The most common clinical presentation is localized lymphadenopathy. Ocular signs, which are common in congenitally acquired toxoplasmosis, may rarely be the only manifestation of acquired systemic toxoplasmosis. It has been suggested that concomitant infection with a dna virus, such as CMV or herpes simplex virus, may facilitate the penetration of protozoa into cells, or that antigenic stimulation from toxoplasma antigens may activate endogenous latent CMV in the recipient. The occurrence of ocular involvement during toxoplasmosis and its association with a dna virus is reviewed.- - - - - - - - - - ranking = 0.031311783406353keywords = cytomegalovirus (Clic here for more details about this article) |
6/39. Presumed acquired ocular toxoplasmosis in deer hunters.PURPOSE: To describe acquired ocular toxoplasmosis in deer hunters. methods AND RESULTS: The authors describe five young men presenting with flu-like symptoms followed by visual loss due to a unilateral, focal necrotizing retinitis. All five men gave a history of ingesting undercooked or uncooked venison. All five had elevated toxoplasma serology, and all five improved clinically with an antitoxoplasma regimen. CONCLUSION: In previously healthy young men, flu-like symptoms associated with visual loss and retinitis should prompt questioning about hunting and raw game meat ingestion, especially when toxoplasmosis is suspected.- - - - - - - - - - ranking = 2keywords = retinitis (Clic here for more details about this article) |
7/39. toxoplasma gondii retinochoroiditis after cardiac transplantation.PURPOSE: To report 4 cases of toxoplasma gondii retinochoroiditis in patients having recently undergone cardiac transplantation. methods: review of medical records for 4 patients presenting retinochoroiditis and evidence of T. gondii infection. RESULTS: Patient ranged in age from 25 to 53 years. Ocular symptoms began between 3 and 6 months after transplantation. All patients were under immunosuppressive therapy. Foci of retinochoroiditis were observed unilaterally in three patients and bilaterally in one. Intraocular inflammation was minimal in all cases. Serologic responses were highly suggestive of T. gondii as the etiology in all cases; other causes (CMV retinitis and syphilis) were actively sought and were not found. All patients underwent classic therapy. The three unilateral cases evolved favorably, but the bilateral case, seen late, showed extensive macular scarring. CONCLUSION: Infectious retinochoroiditis is a potentially blinding complication seen after cardiac transplantation, justifying close clinical and serological surveillance or, in certain cases such as mismatched donors, anti-parasitic prophylaxis.- - - - - - - - - - ranking = 1keywords = retinitis (Clic here for more details about this article) |
8/39. Ocular toxoplasmosis presenting as neuroretinitis: report of two cases.BACKGROUND: Neuroretinitis is a clinical entity usually seen in young healthy adults, that is characterized by rapid profound unilateral loss of vision and includes optic nerve head edema, splinter hemorrhages, macular exudate in a stellate pattern, and variable vitreous inflammation. There are numerous entities that can cause a picture of neuroretinitis ranging from vascular to infectious to autoimmune. PATIENT AND methods: We report two patients with neuroretinitis, who presented with unilateral blurred vision and had serologic evidence of toxoplasma gondii infection. RESULTS: Both patients responded well to treatment with systemic antibiotics and corticosteroids. visual acuity returned to 20/60 in one patient and 20/20 in the other. CONCLUSION: Although the etiology is usually idiopathic, infectious causes of neuroretinitis, including toxoplasmosis, should be kept in mind in order to maintain visual acuity by early diagnosis and appropriate therapy.- - - - - - - - - - ranking = 8keywords = retinitis (Clic here for more details about this article) |
9/39. Frosted branch angiitis and late peripheral retinochoroidal scar in a patient with acquired toxoplasmosis.PURPOSE: To report a case of acute frosted branch angiitis associated with acquired toxoplasmosis in which a late peripheral chorioretinal scar developed. RESULTS: A 32-year-old man without systemic symptoms presented with sudden visual loss in his left eye. Examination demonstrated frosted branch angiitis without necrotizing chorioretinitis. serologic tests showed elevated toxoplasma gondii-specific immunoglobulin m antibody titers. Antitoxoplasmic therapy and oral steroids healed the ocular inflammation. In a follow-up visit one year later, a peripheral chorioretinal scar was noted. CONCLUSIONS: Acute frosted branch angiitis without focal necrotizing chorioretinitis can be a manifestation of acquired toxoplasmosis. This could be an important, and sometimes forgotten, sign of the disease.- - - - - - - - - - ranking = 2keywords = retinitis (Clic here for more details about this article) |
10/39. Aggressive toxoplasma retinitis.toxoplasma infection is a common cause of infectious uveitis. It usually produces a characteristic fundal appearance, with evidence of previous inflammation. However, it may occur in an atypical and aggressive form. steroids administered to salvage vision may then worsen the clinical course. Retinal biopsy may be diagnostic in cases where doubt exists. We illustrate these points with two cases.- - - - - - - - - - ranking = 4keywords = retinitis (Clic here for more details about this article) |
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