Retinochoroidal Manifestation of Toxoplasmosis in a Young Patient

Case Report

Austin J Clin Ophthalmol. 2023; 10(5): 1157.

Retinochoroidal Manifestation of Toxoplasmosis in a Young Patient

Nury Serdarov¹; Agajan Muradov¹; Galina Mamedowa¹; Ogulnur Baýrammuhammedova¹; Gozel Shirlieva¹; Mayagozel Zhutdieva¹*

¹International Center of Endocrinology and Surgery Ashgabat, Turkmenistan

²International Center of Eye Diseases Ashgabat, Turkmenistan

*Corresponding author: Mayagozel Zhutdieva Department of Consultative and Diagnostic, International center of Endocrinology and Surgery Atatürk (1972) street № 94, Ashgabat, 744028, Turkmenistan Tel: + 993 64 207526 Email: [email protected]

Received: April 17, 2023 Accepted: May 13, 2023 Published: May 20, 2023


We report the case of a 15-year-old young girl, with retinochoroidal manifestation of toxoplasmosis, without vitritis. Serology for Toxoplasma gondii was positive (IgG positive /IgM negative), but PCR for Toxoplasma gondii in peripheral blood samples was negative. Blood tests including complete hemogram (total leukocyte, red blood cell and platelet count) except for hemoglobin, coagulogram (APTT, INR, and fibrin degradation product level) and routine blood biochemistry (serum urea, creatinine, and random blood sugar) were within normal limits. The serum levels of triglycerides, low density lipoproteins, high-density lipoproteins and calcium were within normal limits. Direct ophthalmoscopy of the right eye revealed a well-demarcated circular atrophic pigmented scar of about four disc diameters involving the macula. We did not initiate any therapy, because the process appeared to be active anymore. In our case demonstrate of retinochoroidal manifestation of toxoplasmosis by routine fundus examination in a young patient with uncharacteristic complaints.

Keywords: Toxoplasma gondii; Ocular toxoplasmosis; Atrophic scar


The significance of the problem of toxoplasmic etiological manifestations is determined by their prevalence in warm-blooded mammals including humans, irreversible changes in the retina and choroid, as well as the severity and recurrent nature of the disease [1,2]. Toxoplasmosis infection is widespread throughout the world. It is caused by the obligate intracellular parasite Toxoplasma gondii for which members of the cat family are the definitive hosts. Oocysts in the cat intestine are released and spread in fecal material directly to humans and/or indirectly via the consumption of raw or partially-cooked meat prepared from other infected animals, such as pigs, sheep and chicken [3].

Ocular toxoplasmosis accounts for 15% to 17% of all intraocular inflammatory diseases. In Europe, it is the cause of more than 25% of all posterior uveitis cases [4-6]. The global prevalence of ocular toxoplasmosis strongly varies between countries and regions. For example, it is 1.8% in Japan, 8.4% in the U.S., 22.2% in Thailand and 39.8% in Colombia [7-10].

Approximately 24% patients have a blurring of vision and visual loss during acute toxoplasma retinochoroiditis involving vitreous body as a result of formation macular scar and/or optic atrophy [10-11]. Visual field loss associated with severe course of toxoplasmasmic retinochoroiditis and as a result scarring occurs close in the area of the optic disc [12]. Here we report on the clinical evolution of a retinal lesion in a young patient.

Case Presentation

We report on a case of a 15-year-old girl with decreased vision in the right eye. From the patient’s history, it is known that the patient went to the International Center of Endocrinology and Surgery Ashgabat, Turkmenistan, for difficulties with nasal breathing (nasal polyps). During a conversation with an otorhinolaryngologist, it became obvious that she also complained of poor vision in her right eye for about two years. Therefore, the patient was sent to an ophthalmologist for consultation. She was not on any local or systemic medications nor had she a family history of eye illnesses. She was not aware of any close contact with animals, about the last 3 years. However, the patient said that over the past 2 years, she sometimes consumed only lightly fried steak.

Ophthalmological Examination

On examination, visual acuity was finger counting in the right (OD) and 20/20 in the left eye (OS). Intraocular pressure was 16 mm Hg bilaterally. Slit-lamp examination revealed transparent bulbar conjunctiva and cornea, deep, clear and quiet anterior chamber with open angles, flat and intact irides. Furthermore, pupils were normal in size and shape and reactive to light, and the lens was clear. Posterior segment examination excluded vitreous haze or cells in either eye. By direct ophthalmoscopy, there was a clear view of the posterior pole in the uninfected fellow eye. The optic disc, retinal vessels, and the macula appeared normal (Figure 1b). Fundoscopic examination of the infected right eye revealed a hyperpigmented round - retinochoroidal scar of yellowish- whitish color and dark borders in the area of the macula. The size was around four diameters of the optic disc. Within the focus, there was an atrophy of the retina and the underlying uvea (Figure 1a).