Third-Generation Optical Coherence Tomography Findings in Punctate Retinal Toxoplasmosis

Purpose: To investigate optical coherence tomography (OCT) findings in patients with punctate retinal toxoplasmosis (PRT). Design: Observational case series. Methods: Setting: Tertiary ophthalmic referral center. Study Population: Four patients with PRT consecutively evaluated between July 2004 and June 2005. Observation Procedures: Clinical examination and OCT. Main Outcome Measures: Morphologic features at baseline and changes within a 24-week follow-up interval. Results: Retinal layers were abnormally hyperreflective at the active lesion site and associated with some degree of retinal pigment epithelium-choriocapillaris/choroidal optical shadowing in all patients. The posterior hyaloid was thickened and focally detached (over the lesion). Additional findings include tractional maculopathy (n = 2) and diffuse macular edema (n = 1). During follow-up, focal choriocapillaris/choroidal relative hyperreflectivity was observed at the former lesion site, and posterior vitreous detachment progressed in all patients. Conclusions: Our findings suggest that OCT may enable identification of subtle morphologic features previously underappreciated in patients with PRT, which may provide new insights about the disease pathophysiologic mechanisms.