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Unilateral Toxoplasma retinochoroiditis with frosted branch angiitis: a multimodal imaging study
  1. Srinivasan Sanjay,
  2. Ayushi Choudhary,
  3. Ankush Kawali and
  4. Padmamalini Mahendradas
  1. Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
  1. Correspondence to Dr Srinivasan Sanjay; sanjaygroup24{at}gmail.com

Abstract

A woman in her late 30s presented with sudden diminution of vision, redness and pain in the right eye (OD) of 10 days’ duration. Best corrected visual acuity (BCVA) was 20/160 in OD and 20/20 in the left eye (OS). Anterior segment of OD showed keratic precipitates, flare 3+, cells 2+ and a festooned pupil. Vitreous haze and cells were seen in OD. Frosted branch angiitis (FBA) was seen in all quadrants in OD and old Toxoplasma scar was seen in both eyes. Serum toxoplasma immunoglobulin G (IgG) was positive and IgM negative, and PCR of an aqueous humour sample was negative for Toxoplasma. She was diagnosed with toxoplasa retinochoroiditis in OD and treated with intravitreal clindamycin injections, oral anti-Toxoplasma antibiotics and steroids. Three months later, her BCVA in OD was 20/40 with resolving inflammation. She presented 2 months later with a new focus of retinochoroiditis without FBA and an old Toxoplasma scar.

  • Eye
  • Infectious diseases
  • Medical management

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Footnotes

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  • Contributors SS was responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing of original diagrams and algorithms and critical revision for important intellectual content. AC was involved in drafting of the text, sourcing and editing of clinical images and investigation results. AK and PM were involved in critical revision for important intellectual content. All authors gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.