Dr.Manogya Jain

Dr.Samyak Mulkutkar, None

Abstract

69 Y/F presented with diminution of vision in right eye since 15 days. She was diagnosed as choroiditis & started on oral steroids elsewhere. When referred to our centre, RE showed dense vitritis, one major arteriolar occlusion & 360° occlusion of vessels. A tongue shaped active retinitis was seen superio-nasally in periphery. LE was normal. Clinical diagnosis of acute retinal necrosis of viral origin was made & oral Valacyclovir 1gm TDS promptly started. Inflammation improved & oral steroids added. But active retinal traction was noted & improvement plateaued. Hence, 25G PPV vitreous sampling was done. Toxoplasma PCR was positive from vitreous & treatment was revised to oral trimethoprim & sulfamethoxazole DS BD. Oral antivirals & steroids were stopped. Subsequently, retinitis started healing, inflammation & vision improved. Atypical presentations of ocular toxoplasmosis can mimic classic acute viral retinitis. Diagnostic vitrectomy or aqueous sampling may prove results effectively.