Retinal vascular involvement in acute toxoplasmic retinochoroiditis

Abstract

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).

Active ocular toxoplasmosis in Turkish patients: a report on 109 cases

“…While 33% of the eyes had retinal periphlebitis based on clinical examination, retinal vascular staining or leakage was observed in 43% of the eyes that were examined by fluorescein angiography. Theodossiadis and associates reported retinal vascular involvement in 100% of 64 patients with acute toxoplasmic retinochoroiditis in a study where flurescein angiography was included in the routine examination [26]. On the other hand, Atmaca and associates reported retinal vascular fluorescein leakage in 33% of eyes, similar to the percentage we found on clinical examination [27].…”

Retinal Vasculitis

“…Anterior uveitis, which may be granulomatous, and a secondary rise in intraocular ocular pressure may also be noted. There may be an associated retinal vasculitis, which may be either near to or distant from the focus of active retinochoroiditis 27 (Fig. 5).…”

A clinical approach to the diagnosis of retinal vasculitis

“…The arteries are often affected. Kyrieleis arteriolitis refers to accumulation of periarterial exudates, which can occur either in the vicinity of the acute retinitis or elsewhere in the retina [41]. In rare cases, the vasculitis may be occlusive, resulting in retinal infarction and consequent visual field defects.…”