A Case of Ocular Toxoplasmosis Presenting With Neuroretinitis

Abstract A 33-year-old female patient who followed up in an external center with the diagnosis of optic neuritis 2 years ago, had complaints of decreased vision and headache for 1 week. In our examination, visual acuity was counting fingers from 2 meters in the right eye and 1.0 in the left eye with a Snellen chart. Bilateral anterior segment was normal in slit-lamp examination. Color vision was 0/12 in the right eye and 12/12 in the left eye. In dilated fundus examination, optic nerve head edema was present in the right eye, while the optic nerve, macula and retina of the left eye were normal. In the visual field, an inferior arcuate visual field defect was observed in the right eye. Anti Toxoplasma IgM resulted in 1,240 IU/mL (positive) and IgG 90.5 IU/mL (positive). Optical coherence tomography showed pigment epithelial detachment adjacent to the optic disc. Trimethoprim/sulfamethoxazole 800/160 mg 2x1, azithromycin 1000 mg loading followed by 500 mg 1x1 (1 week) was started. On the 3rd day of the treatment, prednisolone 1mg/kg/day weekly reduction regimen was started. There was a macular star appearance with hard exudates in the macula with a rapid recovery with treatment. At the 6th month follow-up, visual acuity was 0.5 in the right eye and 1.0 in the left eye, while anterior segment slit-lamp examination was normal. In dilated fundus examination, the temporal part of the optic disc was pale and macular hard exudates were present in the right eye; and the left was normal.