Toxoplasmic chorioretinitis with unilateral disc edema

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Identifier EEC_Toxoplasmosis_final
Title Toxoplasmic chorioretinitis with unilateral disc edema
Subject Toxoplasmosis, uveitis, retinochoroiditis, optic disc edema
Creator Rahul A. Sharma, MD, MPH, Neuro-ophthalmology Fellow, Department of Ophthalmology, Emory University School of Medicine; Nancy J. Newman, LeoDelle Jolley Chair in Ophthalmology, Professor of Ophthalmology and Neurology, Instructor of Neurosurgery, Departments of Ophthalmology, Neurology and Neurosurgery, Emory University School of Medicine; Valérie Biousse, MD, Cyrus H. Stoner Professor of Ophthalmology, Professor of Ophthalmology and Neurology, Departments of Ophthalmology and Neurology, Emory University School of Medicine
Description A 53-year-old man had a history of high myopia and a seronegative spondyloarthropathy treated with immunosuppressive agents. He presented with mild, painless vision loss in his right eye. His examination showed findings of a right anterior optic neuropathy: visual acuity: 20/20 OD (right eye), 20/20 OS (left eye); pupils: new 1+ right relative afferent pupillary defect; optic disc edema OD. His initial work-up included a normal MRI brain/orbits with contrast, and negative or normal RPR, CBC, ESR, CRP, bartonella serology, anti-AQP4 and anti-MOG antibodies. Color photographs centered on the optic nerves show findings related to the patient's high myopia (tilted optic nerves with peripapillary atrophy bilaterally). The right optic nerve is edematous with peripapillary whitening. Humphrey visual fields (HVF, 24-2 SITA Fast) show a nasal step defect OS (related to the patient's tilted optic discs) and a new inferior arcuate visual field defect OD. OCT macula of the right eye shows vitreous opacities suggestive of vitritis in the right eye.; ; Based on the presence of chorioretinal inflammation and vitritis, the patient was diagnosed with a posterior uveitis OD. Concern was for an infectious chorioretinitis. A vitreous sample returned positive for toxoplasmosis. The patient was treated with oral sulfamethoxazole / trimethoprim and oral prednisone. After initial worsening, the uveitis resolved and a chorioretinal scar appeared.
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2020
Type Text; Image
Format application/pdf
Rights Management Copyright 2020. For further information regarding the rights to this collection, please visit:
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s6x97p0x
Setname ehsl_novel_eec
Date Created 2020-04-30
Date Modified 2020-04-30
ID 1546476
Reference URL
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