Sequential optical coherence tomography images of retinal necrosis in acute ocular toxoplasmosis

Purpose: To describe the features of sequential spectral-domain optical coherence tomography (OCT) images in an eye with acute primary toxoplasmosis. Methods: Case report of an individual diagnosed with acute primary toxoplasmic retinochoroiditis. Initial and follow-up spectral-domain OCT findings are described. Results: This patient developed retinitis as a result of an acute infection consistent with Toxoplasma gondii suggested by toxoplasma-specific IgM serology and the response to therapy. The retinitis appeared initially as a hyperreflective region on spectral-domain OCT. An intraretinal cyst consistent with T. gondii parasitic infection was identified. Subsequent OCT images demonstrated progression to full-thickness retinal necrosis with the development of cystic spaces in the retina. Conclusion: Optical coherence tomography may be useful in characterizing the features, extent, and location of retinitis caused by T. gondii. Specific OCT features may indicate whether the infection is acute phase or becoming quiescent.