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Vitreoretinal traction and lamellar macular holes associated with cicatricial toxoplasmic retinochoroiditis: Case series report

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Rodríguez, Alvaro
Valencia, Marcela
Gomez, Flor E.



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Wichtig Publishing Srl

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Purpose: Inflammation due to retinal neuroepithelial necrotic granulomas of toxoplasmosis can extend to neighbor areas and may develop focal adhesions of the posterior hyaloid, to the surface vessels, and the margins or adjoining areas of retinochoroiditis plaques.These adhesions may develop vitreoretinal traction and retinal tears.Vitreoretinal traction may be macular (VMT) or extramacular depending on the location of the toxoplasmic plaques.Vitreomacular traction may follow anomalous posterior vitreous detachment.We report 7 cases of vitreoretinal traction (macular or peripheral) and the development of 4 lamellar macular holes in cicatricial toxoplasmic retinochoroiditis.Methods: This is a retrospective and observational study by revision of clinical records in a retinologist office, using diagnostic techniques, especially optical coherence tomography (OCT), current management, and an extended follow-up.The OCT observations on toxoplasmic extramacular plaques are more difficult.Results: Seven cases in 5 patients, 2 of them bilateral, 3 male (66.6%) and 2 female, median age 46 years, were included.Anteroposterior VMT was found in 6 cases and another case was superotemporal midperipheral; 4 developed lamellar macular holes and 3 chronic macular epiretinal membranes.Best-corrected visual acuity was equal to or better than 20/30 in 3 cases, between 20/50 and 20/80 in 2 cases, and 20/160 to 20/200 in 2 cases.One small lamellar macular hole closed spontaneously during follow-up.Conclusions: Inflammatory retinal granulomas of toxoplasmosis in cicatricial stages may present macular or peripheral focal vitreoretinal adhesions that can eventually lead to VMT and subsequent lamellar macular holes or peripheral retinal tears. © 2016 Wichtig Publishing.
Palabras clave
Immunoglobulin G , Ocular , Adolescent , Adult , Aged , Article , Capsulotomy , Cataract , Chorioretinitis , Clinical article , Enzyme linked immunosorbent assay , Female , Fluorescence angiography , Follow up , Human , Intraocular pressure , Laser coagulation , Lens implant , Male , Middle aged , Observational study , Ophthalmoscopy , Phacoemulsification , Priority journal , Retina detachment , Retinal nerve fiber layer thickness , Retrospective study , Spectral domain optical coherence tomography , Surgical drainage , Toxoplasmosis , Visual acuity , Visual impairment , Vitreoretinopathy , Young adult , Case report , Eye Diseases , Optical coherence tomography , Parasitology , Pathology , Procedures , Retinal Diseases , Retinal Perforations , Tissue adhesion , Toxoplasmosis , Vitreous body , Adolescent , Aged , Eye Diseases , Female , Humans , Male , Middle Aged , Retinal Diseases , Retinal Perforations , Retrospective Studies , Tissue Adhesions , Tomography , Toxoplasmosis , Visual Acuity , Vitreous Body , Young Adult , Adhesions , Macular hole , Retinochoroiditis , Toxoplasmosis , Vitreomacular traction
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