Ocular Toxoplasmosis
A patient with history of amblyopia presented for two days vision loss and eye pain in the right eye. She denies prior trauma. She was born in Russia and denies exposure to cats. Vision was hand motion in the affected eye with normal intraocular pressure. Exam was notable for focal vitreous inflammation, optic nerve edema with sectoral pallor/whitening, vascular sheathing, retinal whitening of the inferior macula, and retinal hemorrhages. The patient was treated with intravitreal clindamycin and dexamethasone and started on oral antibiotics. She was later found to be Toxoplasma IgG positive and started on oral prednisone. Eye pain and inflammation slowly improved; however, vision remained hand motion with notable optic nerve atrophy seen as vitreous inflammation and optic nerve edema improved. Imaging after clinic improvement showed multiple atrophic appearing retinal lesions, one peripapillary. Visual field testing showed dense superior visual field defect in the affected eye. The patient continues on oral antibiotic prophylaxis.
Presentation Date: 03/06/2025
Issue Date: 05/16/2025
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