Multifocal Necrotizing Chorioretinitis Following Phacoemulsification Surgery. (June 2015)

• Record Type: Journal Article
• Authors: Yusuf, Imran H.; Izadi, Shahrnaz; Fung, Timothy H. M.; Sallam, Ahmed; Patel, C. K.
• Is Part Of: Ocular immunology and inflammation. Volume 23:Number 3(2015)
• Page Start: 261
• Page End: 265
• Publication Date: 2015-06
• Subjects: Eye -- Diseases -- Immunological aspects -- Periodicals; Eye -- Inflammation -- Periodicals; 617.7
• DOI: 10.3109/09273948.2014.891756
• Languages: English
• ISSNs: 0927-3948

Abstract

<abstract> <title>Abstract</title> <p> <italic>Introduction</italic>: <italic>Toxoplasma</italic> chorioretinitis is a leading cause of infectious posterior uveitis worldwide.</p> <p> <italic>Methods</italic>: We report an atypical presentation of <italic>Toxoplasma</italic> chorioretinitis presenting after uneventful cataract surgery in an 81-year-old male, with known hypernephroma and rheumatoid arthritis, treated with prednisolone and methotrexate.</p> <p> <italic>Results</italic>: He was treated for acute retinal necrosis and cytomegalovirus retinitis before <italic>Toxoplasma</italic> chorioretinitis was confirmed by vitreous biopsy 11 months after presentation. He developed a secondary rhegmatogenous retinal detachment, treated successfully with pars plana vitrectomy, silicone oil and endolaser. Visual acuity at discharge was 6/12 following silicone oil removal.</p> <p> <italic>Discussion</italic>: Necrotising chorioretinitis in immunosuppressed or elderly patients may present with an atypical phenotype. Clinical diagnosis in this context remains challenging. We discuss the clinical reasoning behind investigation and management of this patient group in whom viral and <italic>Toxoplasma</italic> retinitis may be clinically indistinguishable. The significance of vitreous PCR results in clinical decision making in the context of infectious posterior uveitis is discussed.</p> </abstract>