First Author: M.Citirik TURKEY
Co Author(s): A. Kocak Altintas M. Teke
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To report a case of intrachoroidal cavitation associated with ocular toxoplasmosis
Description of a clinical case of a patient followed in Ophthalmology Consult - Ophthalmology Department of Ulucanlar Eye Education and Research Hospital - Ankara, Turkey.
A 42 year old woman was diagnosed as having ocular toxoplasmosis in her both eyes regarding his retinochoroidal lesions and serological investigations.
Best-corrected visual acuity was 20/50 in her right eye and 20/1250 in the left. Intraocular pressures with applanation were 17 mmHg OD and 15 mmHg OS respectively. Anterior segment examination of the right eye was found to be normal except for moderate cortical cataract. Also anterior segment of the left eye was found to be normal except for mild cortical cataract. Fundus examination of the right eye showed chorioretinal scar is found in the inferotemporal and superior fundus periphery outside the vessel arcade. Fundus examination of the left eye showed a large healed excavated scar at the fovea with central retinochoroidal atrophy. Also, chorioretinal scar is found in the inferonasal fundus periphery. Fundus autofluorescence photographs of right eye show hypoautofluorescence in the areas of chorioretinal scar with atrophic retinal pigment epithelium. Fundus autofluorescence photographs of left eye show large hypoautofluorescence in the fovea and inferonasal fundus concordant with the chorioretinal scar. Optical coherence tomography of right eye showed retinal atrophy at the site of scarred areas of retinochoroiditis. Optical coherence tomography of left eye revealed an excavated area to the base of the lesion. Also, nonreflective cavity within the outer choroid along the nasal border of foveal scar was observed.
: Intrachoroidal cavitation does not occur exclusively in eyes with high myopia. A posterior excavation may leads to a mechanical stretch of the structurally weaker area and the surrounding tissue, resulting in splitting of the intrachoroidal structures and formation of cystoid spaces. These cystoid spaces may enlarge and coalesce to form a large cystic area seen as a hyporeflective space on optical coherence tomography. Also, choroidal schisis or a fluid may be derived from the vitreous fluid gains access into the choroidal tissue.