Branch Artery Obstruction Caused by Acute Toxoplasmosis

Braunstein, Robert A.; Gass, Jörn‐Markus

doi:10.1001/archopht.1980.01020030508015

Cited by 48 publications

(22 citation statements)

References 8 publications

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“…Several vascular manifestations have been found in patients with ocular toxoplasmosis [3,[5][6][7][8][14][15][16][17][18][19][20][21]. These include branch retinal artery or venous occlusion, perivasculitis, and choroidal vascular occlusion in the acute phase.…”

Section: Introductionsupporting

confidence: 39%

“…During the acute phase of toxoplasmic retinochoroiditis, apart from perivasculitis, obstruction of a branch of the central retinal artery and vein as well as choroidal vascular occlusion have also been reported to occur [3,5,6,16,21].…”

Section: Discussionmentioning

confidence: 45%

“…Other, less common ocular findings, such as papillitis, neuroretinitis, scleritis, pars planitis, and retrobulbar neuritis have also been observed [5,[6][7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 45%

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Retinal vascular involvement in acute toxoplasmic retinochoroiditis

Theodossiadis¹,

Kokolakis²,

Ladas³

et al. 1995

Int Ophthalmol

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The present study deals with the retinal vascular involvement in 64 patients with toxoplasmic retinochoroiditis during the acute phase of the disease and its evolution. Vascular involvement was noted in all 64 eyes during the acute phase of the disease. In 59 (92%) out of 64 cases the vascular involvement was located in the same retinal quadrant as the active toxoplasmic lesion. In the remaining 5 eyes (8%) the vascular participation was found in all four retinal quadrants. In 3 (5%) out of 64 cases, the vascular infiltration was extremely severe and resulted in retinal vascular obstruction. In all three cases the vessel traversed the active toxoplasmic lesion. In 35 (55%) out of 64 patients the initial vascular picture changed in the course of the acute phase of the disease. In these patients, the lesions had extended to the adjacent vessels or to other parts of the involved vessel. In the further course of the evolution of the active toxoplasmic lesion, the vascular involvement did not persist indiscriminately. It was noted that in 14 (22%) out of 64 cases the vascular lesions gradually regressed and eventually disappeared together with the active toxoplasmic lesion and the formation of the retinochoroidal scar. In the remaining 50 (78%) out of 64 cases the vascular involvement either disappeared after the establishment of the retinochoroidal scar in 3-12 months (29 cases) or remained permanently (21 cases).

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Section: Introductionsupporting

confidence: 39%

Section: Discussionmentioning

confidence: 45%

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Retinal vascular involvement in acute toxoplasmic retinochoroiditis

Theodossiadis¹,

Kokolakis²,

Ladas³

et al. 1995

Int Ophthalmol

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“…Simultaneous combined occlusion of both the artery and the vein can be found but is rare. Other vascular involvement includes retinal or choroid neovascularization, periphlebitis, periarteritis, perivascular sheathing, and segmental retinal periarteritis (Kyrieleis arterialitis) [305][306][307][308][309][310]. Kyrieleis arterialitis is different from vascular occlusion, as it does not impede blood flow, does not show leak with fluorescein angiography, fades slowly with time, and can occur distant to the focus of active retinitis.…”

Section: Clinical Picturementioning

confidence: 39%

Immunopathogenesis of toxoplasmosis

Hegab

Al-Mutawa²

2003

Clinical and Experimental Medicine

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Toxoplasmosis is a ubiquitous infection affecting 500 million persons around the world, with a range of incidence 12%-90%, increasing with age, education, crowding and sanitary habits. Cats are the definitive host. Infection is primarily congenital but acquired ocular infection has been documented. The review focuses on the immunopathogenesis of toxoplasmosis with emphasis on the eye problem due to its morbidity. The response to infection correlates with both parasitic and retinal antigens. The clinical picture and histopathology is a reflection of the immune response which constitutes early humeral response which presents both systemically and locally primary infection and is elevated with reactivation. This is followed by the cellular response, varying from low grade monocular infilterate a total tissue destruction with response of live parasites especially in immuno-compromised patients. Penetration of the parasite and its enclosure within the parasitophorous vacuole and its eneyst all make its eradicatier impossible. This reflects the variability of antiparasitic therapy that include folate antagonists, macrolides, hydroxy naphthoquindones and fluoroquinolones. Use of corticosteroid should be limited to severe reactions and should be associated with specific therapy.

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“…Branch retinal artery occlusion (BRAO) is usually found in association with emboli in older patients [ 16] and, in younger patients, may accompany retinal toxoplasmosis [17], ocular trauma [18], atrial myxoma [18], collagen vascular disease [19], and other causes of vasculitis [20]. To the best of our knowledge, BRAO has not previously been described in association with HIV infection, AIDS, and CMV retinitis.…”

Section: Discussionsupporting

confidence: 41%

Branch retinal artery occlusion (BRAO) combined with branch retinal vein occlusion (BRVO) and optic disc neovascularization associated with HIV and CMV retinitis

1995

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Two vaso-occlusive events, branch retinal artery occlusion (BRAO) and branch retinal vein occlusion (BRVO), were observed in the retina of an HIV-infected patient with cytomegalovirus (CMV) retinitis who developed neovascularization of the disc (NVD). Although BRVO and reversible NVD have been reported in association with CMV retinitis, we have seen no reports of concomitant BRAO. CMV damages endothelial cells and causes an occlusive vasculitis. In HIV-infected individuals, damaged endothelial cells and rheologic problems result in increased blood viscosity. HIV infection has also been associated systemically with elevated levels of cytokines, including tumor necrosis factor alpha (TNF-alpha). In vitro, TNF-alpha exerts effects that decrease fibrinolytic potential; this activity in the circulation of a patient with AIDS may lead to vascular occlusive events. In the patient reported here, the retinal changes were not reversed by induction therapy with ganciclovir and the NVD did not regress.

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Branch Artery Obstruction Caused by Acute Toxoplasmosis

Cited by 48 publications

References 8 publications

Retinal vascular involvement in acute toxoplasmic retinochoroiditis

Retinal vascular involvement in acute toxoplasmic retinochoroiditis

Immunopathogenesis of toxoplasmosis

Branch retinal artery occlusion (BRAO) combined with branch retinal vein occlusion (BRVO) and optic disc neovascularization associated with HIV and CMV retinitis

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