A Unique Case of Neuroretinitis and Branch Retinal Artery Occlusion Associated with an Acute Toxoplasmosis Lesion - Abstract
Purpose: We describe a unique case of ocular toxoplasmosis associated with concurrent neuroretinitis and a branch retinal artery occlusion (BRAO).
Observation: We report the case of a 35-year-old woman who presented with sudden-onset right inferonasal visual field loss and blurry vision. Initial
clinical examination demonstrated visual acuity of 20/30, optic disc edema, macular exudates, subretinal fluid, and a filling defect in the superior temporal
retina consistent with neuroretinitis and BRAO. Serologic testing was positive for both Toxoplasma IgM and IgG antibodies. The patient was treated with
160mg trimethoprim-800mg sulfamethoxazole twice daily for three months and a systemic corticosteroid taper. Visual acuity recovered to 20/20, and signs of
intraocular inflammation resolved; however, a persistent inferonasal visual field defect remained due to the BRAO from the toxoplasmic retinochoroidal lesion.
Follow-up over one year later showed no recurrence or new symptoms.
Conclusion: This case highlights a unique, concurrent presentation of neuroretinitis and BRAO caused by ocular toxoplasmosis. Prompt diagnosis and
treatment resulted in favorable structural and visual outcomes. Toxoplasmosis should be considered in the differential diagnosis for neuroretinitis and retinal
artery occlusions, especially in the presence of intraocular inflammation.