Summary
Patient A 29-year-old white female presented with an episode of recurrent focal toxoplasmic
retinochoroiditis in her right eye. Apart from a white active lesion between the temporal
vascular arcades, marked vitreous opacification was present. Treatment with oral pyrimethamine
and sulfadiazine led to resolution of retinochoroiditis activity including vitreous
clearing within 10 weeks. Another 3 weeks later, a fresh peripheral retinal tear was
noted on routine fundus examination of the right eye. While the left eye showed no
signs of vitreoretinal pathology, biomicroscopy revealed a posterior vitreous detachment
and marked vitreous degeneration in the right eye of this emmetropic patient. Prophylactic
laser treatment was performed. No further abnormalities were observed during a 5 months
follow-up period.
Conclusion Retinal tears (and rhegmatogenous retinal detachment) are rare complications of toxoplasmic
retinochoroiditis. However, a tear may occur due to vitreoretinal traction following
postinflammatory structural alteration of the vitreous. Thus, in toxoplasmic retinochoroiditis
the diagnostic attention should not be limited to the evaluation of optical transparency
of the vitreous. Vitreous structure should be assessed as well and if structural changes
are noted, repeated ophthalmoscopy is mandatory in order to detect retinal tears and
rhegmatogenous retinal detachment timely.
Key words
toxoplasmic retinochoroiditis - retinal tear - retinal detachment - vitreous
Schlüsselwörter
Retinochoroiditis toxoplasmotica - Netzhautforamen - Netzhautablösung - Glaskörper
