Congenital Toxoplasmosis

For a better understanding, refer to the normal fundus and optical coherence tomography images for comparison. This 24-year-old patient was seen in 2009 for congenital toxoplasmosis. This disease usually causes inflammation and chorioretinal scarring in both eyes. Typical symptoms of an activated infection are blurred or decreased vision and floaters. Although he complained of decreased vision, he did not see any floaters. While this infection is not contagious between two people, it can be transferred from a pregnant woman to her unborn child. This case is an example of that. In his right eye, a large inactive toxoplasmosis scar was seen in the macula (yellow arrows). He also had scars in the periphery that are partly hidden in the 2009 image but documented in the fundus montage taken in 2017 (blue arrows). His left eye also had scars in and adjacent to the macula (red arrows) as well as in the periphery (white arrows). His vision at initial visit was 20/200 in the right eye and 20/63 in the left. Six years later his vision in the right eye is count fingers (CF) at 3 feet and 20/80 in the left. His optical coherence tomography (OCT) scans show thinning of the retina over time as well as disorganization of the inner retinal layers (green arrows). Long-term monitoring is ideal and appropriate antibiotics, such as sulfamethoxazole/ trimethoprim, are given to those with new activations.