Fig 1.
Subretinal fluid (SRF) in typical active ocular toxoplasmosis as seen by optical coherence tomography (OCT) (Patient 9, Table 1).
Parts A-D: fundus photos (FP) and OCT images on the initial visit. Part A: a fresh whitish inflammatory lesion superior to the macula in the extramacular area, with intraretinal hemorrhage and SRF surrounding the necrosis. Parts B-D: OCT B-scans corresponding to the lines B-D shown in Part A. Vitreous cells were present with normal retinal structure through the fovea (Part B). In areas surrounding the active lesion, SRF was visable (Part C-D). Full-thickness retina destruction (retinal necrosis) accompanied by largely increased choroidal thickness (744 μm) was present (Part D). Parts E-H: FP and OCT images 6 weeks after the initial visit. Part E: previous whitish inflammatory lesion was smaller without visible SRF. Parts F-H: OCT B-scans corresponding to the lines F-H shown in Part E. Absence of SRF and dramatically lessened vitreous cells in the macula and area around the active lesion were observed (Part F-H). Retina got thinner, but still with full-thickness necrosis at the previous active site (Part H). The choroid thickness decreased to 345 μm (Part H). Parts C1-C2 showed the segmentation of retinal layers in OCT B-scan corresponding to Figure C. Part C3-C5: quantitative measurement results from manual segmentation. Part C3: the color bar showing the correlation of thickness and color range. Parts C4-C5: mean retinal thickness and mean SRF height shown in early treatment diabetic retinopathy study (ETDRS) grid using foveola as the center of the grid. The correlation of numbers and subfields are as follows: 1 = superior outer macula; 2 = temporal outer macula; 3 = inferior outer macula; 4 = nasal outer macula; 5 = superior inner macula; 6 = temporal inner macula; 7 = inferior inner macula; 8 = nasal inner macula; 9 = central subfield). ILM = internal limiting membrane; PR = photoreceptor layer; RPE = retinal pigment epithelium.
Fig 2.
Subretinal fluid (SRF) associated with cystoid macular edema (CME) in one eye with previous diagnosis of ocular toxoplasmosis as seen on optical coherence tomography (OCT) (Patients 16, Table 1).
Parts A1, B1, C1, D1 showed characteristics of SRF and CME seen on OCT B-scans through the fovea. Parts A2, B2, C2, D2 demonstrated mean retinal thickness maps shown in early treatment diabetic retinopathy study (ETDRS) grid. Parts A3, B3, C3, D3 were maps of mean SRF height shown in ETDRS grid. SRF and CME kept relatively unchanged for the first 3 visits, and started to respond to treatment on the 4th visit. Parts E-K revealed absence of SRF in the following visits, after 3 intraocular injection of 1.25 mg bevacizumab. However, CME remained persistent, although minimization at one time point (H) was temporally seen.
Table 1.
General Characteristics of Patients with Active Ocular Toxoplasmosis.
Fig 3.
Subretinal fluid (SRF) in eyes with typical active ocular toxoplasmosis associated with retinal necrosis in the macula as seen on optical coherence tomography (OCT) (Patients 1–8, Table 1).
Parts A1-H1: fundus photos (FP) or infrared (IR) images of the macula overlying with early treatment diabetic retinopathy study (ETDRS) grid, for eyes with active OT. Red arrows in each eye indicated areas with active retinitis. Parts A2-H2: mean retinal thickness maps shown in the ETDRS grid corresponding to the overlapped grid in Figure A1-H1. Parts A3-H3: maps of mean SRF height shown in ETDRS grid corresponding to the overlapped grid in Figure A1-H1. 1 = superior outer macula; 2 = temporal outer macula; 3 = inferior outer macula; 4 = nasal outer macula; 5 = superior inner macula; 6 = temporal inner macula; 7 = inferior inner macula; 8 = nasal inner macula; 9 = central subfield.