Combined branch retinal vein and artery occlusion in toxoplasmosis

Aggio, Fábio Bom; Novelli, Fernando José De; Rosa, Evandro Luis; Nóbrega, Mário Junqueira

doi:10.5935/0004-2749.20160054

Cited by 7 publications

(4 citation statements)

References 6 publications

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“…Aggio et al described a similar case of combined vascular retinal (arterial and venous) occlusion, affecting the inferior temporal arch in a similar way, in a 22-year-old patient. Three months later, during control FA, they did not detect any areas of hypoperfusion [11]. This period is shorter compared to the one described in our case, where there was evidence of ischemia and neovascularization more than 3 years after the onset of the disease.…”

Section: Discussioncontrasting

confidence: 69%

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Ischemic Retinal Vasculitis after Previous Toxoplasma Chorioretinitis

Mitkova-Hristova¹,

Stoyanova²

2022

OJOph

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Introduction: Ischemic retinal vasculitis is an inflammatory disease affecting the retinal vessels. Visual acuity decreases due to macular ischemia, macular edema, neovascularization leading to vitreous hemorrhage, fibrovascular proliferation or tractional retinal detachment. Purpose: To present the case of a patient with ischemic retinal vasculitis. Material and Methods: The case involves a 34-year-old woman. The following tests were performed: complete blood count, biochemistry, coagulogram, rheumatological tests, serum calcium level, angiotensin-converting enzyme, CT of the lungs, MRI of the brain and spine, serological tests for: cytomegalovirus, herpes simplex virus (type 1 and 2), varicella-zoster virus, toxoplasmosis, tuberculosis, syphilis, as well as fluorescein angiography and optical coherence tomography. Results and Discussion: The patient was admitted to the hospital with visual acuity of the right eye, 0.8/0.9, and of the left eye, 1.0. The intraocular pressure in both eyes was normal: 14 mmHg in the right eye and 15 mmHg in the left eye. The following pathological finding was detected in the right eye fundus: an old chorioretinal cicatrix under the inferior temporal vascular arch with an ischemic exudate next to it, occlusion of the inferior temporal retinal arterial and venous branches, neovascularization and a preretinal hemorrhage. Fluorescein angiography showed delayed filling of the affected vessels, neovascularization, and major ischemia in the lower temporal part of the retina. The results of the serological tests for varicella zoster virus, herpes simplex virus type 1 and toxoplasmosis were outside the reference ranges. The patient was treated with Clindamycin and Acyclovir. Emergency laser therapy was performed in the ischemic retina area. Previous toxoplasma chorioretinitis was diagnosed, which had led to ischemic retinal vasculitis with sectoral involvement of the retinal vessels. The patient has been monitored over 3 -4 month periods, showing high visual acuity and stable ocular condition. Conclusion: Patients with ischemic retinal vasculitis are a challenge when it comes to cla-

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Section: Discussioncontrasting

confidence: 69%

“…As a result, the inflammatory process begins in the superficial layers of the retina, after which it progresses and may affect the entire retina, as well as the adjacent structures, i.e. the choroid and vitreous [11].…”

Section: Discussionmentioning

confidence: 99%

Ischemic Retinal Vasculitis after Previous Toxoplasma Chorioretinitis

Mitkova-Hristova¹,

Stoyanova²

2022

OJOph

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“…Because the retinal vascular endothelium is highly vulnerable to T. gondii in comparison to vascular endothelium in other tissues, 15 patients with toxoplasmic retinochoroiditis are at higher risk of developing ischemic or hemorrhagic events. 16 , 17 OCTA may therefore be used for non-invasive assessment of the perfusion of the capillary networks at different levels as well as of the choroidal vessels in the macula, retinal periphery and optic nerve. Some of the changes that have been reported include pure retinal neovascularization, choroidal neovascularization, reduced retinal microvasculature and/or choriocapillaris.…”

Section: Discussionmentioning

confidence: 99%

Neuroretinitis and Juxtapapillary Retinochoroiditis as Atypical Presentations of Ocular Toxoplasmosis

Kabedi

Mwanza

2021

IMCRJ

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We report three cases of optic nerve toxoplasmosis, an unusual form of ocular toxoplasmosis. In one patient, the optic nerve involvement occurred in an eye with a toxoplasmic chorioretinal scar and choroidal neovascularization in the supramacular area, subretinal fibrosis, and pigment epithelium detachment. The other two patients had papilledema without healed or active chorioretinal lesions, but both had retinal hemorrhage and macular involvement. The diagnosis was based on clinical examination and elevated serum toxoplasma antibodies. Optical coherence tomography helped uncover the structural chorioretinal changes. All patients were treated with a combination of oral antitoxoplasmic drugs, oral prednisone, and intravitreal injection of bevacizumab. Visual acuity improved in all of them. Optic nerve involvement in ocular toxoplasmosis must be considered when papilledema occurs both in isolation and/or in the presence of an active or scarred chorioretinal lesion.

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“…Therefore, the extent to which systemic hypertension contributed to the formation of the macroaneurysm is limited, further suggesting that old toxoplasmic vasculitis played a role. In addition, branch retinal vein occlusion (BRVO) has been reported to be associated with retinal toxoplasmosis [ 6 , 7 ]. A chronic BRVO along with its complications – formation of microaneurysms, retinal capillary nonperfusion, and retinal collaterals – is also present in our patient (Fig.…”

Section: Discussionmentioning

confidence: 99%

Ruptured Retinal Arterial Macroaneurysm Secondary to Toxoplasmic Kyrieleis Arteriolitis: A Case Report

Huang

Lee

Rivera

et al. 2017

Case Rep Ophthalmol

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Purpose: The aim of this report was to describe multimodal ocular imaging findings in a patient who presented with a ruptured retinal arterial macroaneurysm (RAM) associated with toxoplasmic Kyrieleis arteriolitis. Methods: We report the case of a 64-year-old man with a history of systemic hypertension and dense amblyopia of the left eye who presented with decreased vision and new floaters in the left eye. Color fundus photography, spectral-domain optical coherence tomography, fluorescein angiography, and indocyanine green angiography were used as diagnostic imaging tools. Results: No signs of hypertensive retinopathy were noted in the right eye. Multiple chorioretinal scars characteristic of previous toxoplasmosis were revealed in the left eye, with one covering most of the macula. Periarterial plaques or Kyrieleis arteriolitis were observed in retinal arteries surrounding the toxoplasmic retinal scars. Multiple RAMs were observed in these vessels, one of which was acutely ruptured. A perivenular plaque associated with a chronic branch retinal vein occlusion (BRVO) was noted along the same arcade at the arteriovenous crossing. Conclusion: RAM formation and BRVO can present as possible long-term complications of toxoplasmic Kyrieleis arteriolitis. This is the first reported case demonstrating an association between toxoplasmic Kyrieleis arteriolitis and RAM formation.

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Combined branch retinal vein and artery occlusion in toxoplasmosis

Cited by 7 publications

References 6 publications

Ischemic Retinal Vasculitis after Previous Toxoplasma Chorioretinitis

Ischemic Retinal Vasculitis after Previous Toxoplasma Chorioretinitis

Neuroretinitis and Juxtapapillary Retinochoroiditis as Atypical Presentations of Ocular Toxoplasmosis

Ruptured Retinal Arterial Macroaneurysm Secondary to Toxoplasmic Kyrieleis Arteriolitis: A Case Report

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