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Chorioretinal Inflammatory Diseases

Case 9-8* Reactivation of Toxoplasmosis Retinitis

Clinical Summary

A 20-year-old man with a history of toxoplasmosis complained of blurry vision and floaters in his left eye for a week prior to examination. His visual acuity was 20/15 in this eye. Ophthalmoscopy (A) showed a gray retinal lesion immediately above the superotemporal arcade, and an older chorioretinal scar superior to this lesion.

Optical Coherence Tomography

OC I (B; white line on A) through the recent lesion delineated a region of enhanced reflectivity within the neurosensory retina corresponding to the retinal inflammation. Within the lesion, focal areas of fragmentation were observed in the reflective band corresponding to the retinal pigment epithelium (RPE), most likely a result of RPE proliferation and hyperpigmentation, A horizontal image (C; black line on A) through the older chorioretinal scar showed a well-defined region of increased backscatter from the choroid consistent with pigmentary atrophy and increased penetration of the probe beam into the deeper retina. The neural retina was thinned in this region.

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