Presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing

Central retinal artery occlusion (CRAO) and multifocal retinitis with perivascular sheathing are rare in ocular toxoplasmosis. We report a case of toxoplasmic CRAO and multifocal retinitis with perivascular sheathing. A healthy 83-year-old male developed left panuveitis. Funduscopic examination of t...

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Autores principales: Arai, Haruka, Sakai, Tsutomu, Okano, Kiichiro, Aoyagi, Ranko, Imai, Ayano, Takase, Hiroshi, Mochizuki, Manabu, Tsuneoka, Hiroshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003269/
https://www.ncbi.nlm.nih.gov/pubmed/24790408
http://dx.doi.org/10.2147/OPTH.S58669
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author Arai, Haruka
Sakai, Tsutomu
Okano, Kiichiro
Aoyagi, Ranko
Imai, Ayano
Takase, Hiroshi
Mochizuki, Manabu
Tsuneoka, Hiroshi
author_facet Arai, Haruka
Sakai, Tsutomu
Okano, Kiichiro
Aoyagi, Ranko
Imai, Ayano
Takase, Hiroshi
Mochizuki, Manabu
Tsuneoka, Hiroshi
author_sort Arai, Haruka
collection PubMed
description Central retinal artery occlusion (CRAO) and multifocal retinitis with perivascular sheathing are rare in ocular toxoplasmosis. We report a case of toxoplasmic CRAO and multifocal retinitis with perivascular sheathing. A healthy 83-year-old male developed left panuveitis. Funduscopic examination of the left eye showed a swollen optic disc and sheathing of the retinal artery with a dense vitreous haze and a white retinal lesion. Serum anti-toxoplasma antibodies were positive in a latex agglutination assay. Vitrectomy was performed to improve visualization of the retinal lesions and for examination of causative microorganisms. A postoperative fundus examination revealed CRAO with optic disc involvement and multifocal retinitis with perivascular sheathing. Qualitative multiplex polymerase chain reaction detected the Toxoplasma gondii B1 gene in ocular fluid from both the aqueous and vitreous humor. The presumed diagnosis of ocular toxoplasmosis was made and treatment was started with prednisone and acetylspiramycin with subsequent improvement. Two months later, the patient developed active retinochoroiditis in the left eye. After 6 weeks of anti-toxoplasma therapy, the disease involuted. Retinal vascular occlusions and multifocal retinitis with perivascular sheathing are rare in toxoplasmosis. This is the first case report of toxoplasmic CRAO and multifocal retinitis with perivascular sheathing. The diagnosis of ocular toxoplasmosis should be considered in patients with retinal artery occlusions and multifocal retinitis with perivascular sheathing associated with inflammation.
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spelling pubmed-40032692014-04-30 Presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing Arai, Haruka Sakai, Tsutomu Okano, Kiichiro Aoyagi, Ranko Imai, Ayano Takase, Hiroshi Mochizuki, Manabu Tsuneoka, Hiroshi Clin Ophthalmol Case Report Central retinal artery occlusion (CRAO) and multifocal retinitis with perivascular sheathing are rare in ocular toxoplasmosis. We report a case of toxoplasmic CRAO and multifocal retinitis with perivascular sheathing. A healthy 83-year-old male developed left panuveitis. Funduscopic examination of the left eye showed a swollen optic disc and sheathing of the retinal artery with a dense vitreous haze and a white retinal lesion. Serum anti-toxoplasma antibodies were positive in a latex agglutination assay. Vitrectomy was performed to improve visualization of the retinal lesions and for examination of causative microorganisms. A postoperative fundus examination revealed CRAO with optic disc involvement and multifocal retinitis with perivascular sheathing. Qualitative multiplex polymerase chain reaction detected the Toxoplasma gondii B1 gene in ocular fluid from both the aqueous and vitreous humor. The presumed diagnosis of ocular toxoplasmosis was made and treatment was started with prednisone and acetylspiramycin with subsequent improvement. Two months later, the patient developed active retinochoroiditis in the left eye. After 6 weeks of anti-toxoplasma therapy, the disease involuted. Retinal vascular occlusions and multifocal retinitis with perivascular sheathing are rare in toxoplasmosis. This is the first case report of toxoplasmic CRAO and multifocal retinitis with perivascular sheathing. The diagnosis of ocular toxoplasmosis should be considered in patients with retinal artery occlusions and multifocal retinitis with perivascular sheathing associated with inflammation. Dove Medical Press 2014-04-23 /pmc/articles/PMC4003269/ /pubmed/24790408 http://dx.doi.org/10.2147/OPTH.S58669 Text en © 2014 Arai et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Case Report
Arai, Haruka
Sakai, Tsutomu
Okano, Kiichiro
Aoyagi, Ranko
Imai, Ayano
Takase, Hiroshi
Mochizuki, Manabu
Tsuneoka, Hiroshi
Presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing
title Presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing
title_full Presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing
title_fullStr Presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing
title_full_unstemmed Presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing
title_short Presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing
title_sort presumed toxoplasmic central retinal artery occlusion and multifocal retinitis with perivascular sheathing
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003269/
https://www.ncbi.nlm.nih.gov/pubmed/24790408
http://dx.doi.org/10.2147/OPTH.S58669
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