Netzhautriß bei Retinochoroiditis toxoplasmotica

 

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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.