Consultant, Uveitis Service Toxoplasmosis Dr. Rathinam Sivakumar HOD - Uveitis Services Dr. Radhika. T Consultant, Uveitis Service Dr. Vedhanayaki Rajesh
Ocular History 37 year old female OD: defective vision – 15 days duration pain and redness – 6 days duration
First Presentation IOP: OD 10mm Hg; OS 12mm Hg OD: VA: OD 3/60 OS 6/6 IOP: OD 10mm Hg; OS 12mm Hg OD: pigmented KP's, AVF 2+ cells fundus: retinochoroiditis over the macula OS: quiet
Investigations Routine baseline investigations TC,DC,ESR,Mantoux and TPHA: within normal limits
Diagnosis Toxoplasma retinochoroiditis
Therapy Azithromycin 500mg OD for 15 days Bactrim DS BD for 6 weeks Oral Prednisolone tapered weekly from 40mg/week to 10mg (4 weeks)
Final Presentation – After 6 Weeks VA: OD 6/60, OS: 6/6 IOP: OD 10mm Hg; OS 12mm Hg OD: AC – quiet; no vitreous cells scar over the macula OS: quiet
Conclusion Most cases of toxoplasmosis are acquired after birth Contaminated water is the source of infection Immunocompetent patients present with focal retinitis, while immunosuppressed patients present with multifocal bilateral lesions Diagnosis is mainly CLINICAL PCR from vitreous aspirate for atypical situations Anti-toxoplasmic therapy with systemic steroid is the currently available treatment