Fluorescein and indocyanine green angiography in ocular toxoplasmosis

Abstract

Purpose: To document fluorescein and indocyanine green angiographic findings in patients with ocular toxoplasmosis.

Methods: Charts of patients with ocular toxoplasmosis who were evaluated with fluorescein and indocyanine green angiograpy were reviewed.

Results: In this study, eight (38%) females and 13 (62%) males with a mean age of 20.3 years were included. Of the 21 patients, five (24%) had bilateral involvement with active or inactive toxoplasmic lesion. There were active lesions in 12 (46%) eyes and inactive lesions in 14 (54%) eyes. Indocyanine green angiograpy showed hypofluorescence of the active and inactive retinochoroiditis lesions at all phases. Hypofluorescent multiple satellite dark dots were observed in 11 (92%) eyes with active retinochoroiditis and in two (14%) eyes with inactive lesions. In two patients with unilateral active toxoplasmic retinochoroiditis, hyperfluorescent plaques were observed in the fellow eyes on indocyanine green angiograpy. The fundus examination and fluorescein angiography of the fellow eyes were normal and had a visual acuity of 10/10. Choroidal neovascularization was observed in two (8%) eyes. In eyes with active inflammation, fluorescein angiography revealed early hypo-fluorescence and late intense hyper-fluorescence with fuzzy margins of the retinochoroiditis lesion (12 eyes), hyperfluorescence of the optic nerve head (four eyes) and leakage from the vessels and/or vascular sheathing (four eyes) and neuroretinitis (one eye).

Conclusion: Toxoplasmic retinochoroiditis is a more widespread inflammation than visible fundus lesions. Indocyanine green angiography is a useful method for evaluating the amount of inflammatory activity and late complications in patients with ocular toxoplasmosis.