Fosted branch angiitis associated with ocular toxoplasmosis: a case series
Accept poster if oral is not possible ?
Yes
Purpose
Frosted branch angiitis (FBA) is a rare and potentially severe retinal condition that may be idiopathic, or associated with infectious or noninfectious immune-mediated diseases, as well as neoplastic masquerade syndromes. This study aims to report seven cases of atypical ocular toxoplasmosis presenting with FBA, in association with obvious or innaparent retinochoroiditis.
Methods
Retrospective chart review of clinical/laboratorial data, and of multimodal imaging.
Results
Seven patients (aged 20–39 years, six females) were identified with FBA associated with toxoplasmic retinochoroiditis (TRC), all with unilateral disease. Visual acuity at presentation ranged from 20/20 to no light perception. In one patient, marked hemorrhagic vasculitis and retina edema precluded early identification of TRC. The other six patients had the vasculitic process associated with an easily detected TRC focus, in the posterior pole in 3 and in the periphery in 4 patients. The typical tomographic pattern of focal retinal hyper-reflectivity/disorganization associated with underlying fusiform choroidal thickening was helpful to define toxoplasmic etiology, in combination with positive serology (IgG) for toxoplasmosis. Following treatment with PO antiparasitic drugs/steroids, all patients showed resolution of TRC and of FBA. Final visual acuity ranged from 20/20 to hand movements.
Conclusion
Ocular toxoplasmosis should be considered in the differential diagnosis of FBA, by pursuing identification of focal necrotizing TRV in this setting, with the help of multimodal imaging, if possible. Late or dismisdiagnosis may lead to severe, irreversible visual loss.
Conflict of interest
No
1
Last name
LARA
Initials of first name(s)
CM
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG)
City
Belo Horizonte
Country
Brazil
2
Last name
ROCHA
Initials of first name(s)
ACH
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG)
City
Belo Horizonte
Country
Brazil
3
Last name
AZEVEDO
Initials of first name(s)
DOM
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG)
City
Belo Horizonte
Country
Brazil
4
Last name
CAMPOS
Initials of first name(s)
WR
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG)
City
Belo Horizonte
Country
Brazil
5
Last name
SANTOS
Initials of first name(s)
DVV
Department
Hospital São Geraldo/HC da Universidade Federal de Minas Gerais (UFMG)
City
Belo Horizonte
Country
Brazil
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