Subretinal Fluid in Eyes with Active Ocular Toxoplasmosis Observed Using Spectral Domain Optical Coherence Tomography

Abstract

PurposeTo describe the clinical finding of subretinal fluid (SRF) in the posterior pole by spectral domain optical coherence tomography (SD-OCT) in eyes with active ocular toxoplasmosis (OT).DesignRetrospective case series.ParticipantsThirty-eight eyes from 39 patients with active OT.MethodsEyes with active OT which underwent SD-OCT were reviewed. SRFs in the posterior pole were further analyzed.Main Outcome MeasuresPresence of SRF; its accompanying features, e.g. retinal necrosis, cystoid macular edema (CME), choroidal neovascularization (CNV); and longitudinal changes of SRF, including maximum height and total volume before and after treatment.ResultsSRF presented in 45.5% (or 15/33) of eyes with typical active OT and in 51.3% (or 20/39) of eyes with active OT. The mean maximum height and total volume of SRF were 161.0 (range: 23–478) µm and 0.47 (range: 0.005–4.12) mm3, respectively. For 12 eyes with SRF related to active retinal necrosis, SRF was observed with complete absorption after conventional anti-toxoplasmosis treatment. The mean duration for observation of SRF clearance was 33.8 (range: 7–84) days. The mean rate of SRF clearance was 0.0128 (range: 0.0002–0.0665) mm3/day.ConclusionsSRF (i.e., serous retinal detachment) is a common feature in patients with active OT when SD-OCT is performed. The majority of SRF was associated with retinal necrosis and reacted well to conventional therapy, regardless of total fluid volume. However, SRF accompanying with CME or CNV responded less favorably or remained refractory to conventional or combined intravitreal treatment, even when the SRF was small in size.

Posterior segment findings by spectral-domain optical coherence tomography and clinical associations in active toxoplasmic retinochoroiditis

“…Published SD-OCT studies have identified subretinal fluid in as many as 43% of patients 20 . Two studies from the same group documented intraretinal and subretinal fluid in SD-OCT scans of TRC, although the authors did not explore clinical associations 10 , 11 . An unusual presentation of outer retinal oedema—“huge outer retinal cystic spaces” 11 —was identified in two of eyes in our series.…”

Presumed Foveal Bacillary Layer Detachment in a Patient With Toxoplasmosis Chorioretinitis and Pachychoroid Disease

“…With the application of multimodal imaging, preretinal vitreous aggregations and retinal cystoid fluid accumulations have been described. 2–8 We describe a case of macular toxoplasmosis chorioretinitis presenting with a retinal detachment that apparently separated photoreceptor inner segment myoids from inner segment ellipsoids, possibly exacerbated by preexisting pachychoroid disease. Described in neovascular macular degeneration as “atypical outer retinal fluid” 9 and in both ocular toxoplasmosis and Vogt–Koyanagi–Harada (VKH) disease as a “huge outer retinal cystic space” 6 and “subretinal fluid with subretinal fibrin accumulation,” 10 we believe the term “bacillary layer detachment” is an appropriate description for this optical coherence tomography (OCT) finding based on recent histologic descriptions of macular cone photoreceptor degeneration.…”

Toksoplazma Koryoretinitine Bağlı Geniş Seröz Makula Dekolmanı: Olgu Sunumu

“…Ouyang ve arkadaşlarının çalışmasında tüm aktif oküler toksoplazmosiz olan gözlerde OKT'de subretinal sıvı prevalansı %51.3 olarak bulunmuştur. Aynı çalışmada subretinal sıvının yerinin aktif retinitin bulunduğu alanla büyük ölçüde ilişkili olduğu ve bu nedenle sıvı birikiminin retinit ve ya retinal nekroza sekonder artmış vasküler geçirgenliğe bağlı olduğu vurgulanmıştır (8).…”