Punctate Inner Retinal Toxoplasmosis: Case Series and Review of Literature

Abstract

Purpose: To describe clinical and multimodal imaging characteristics of punctate inner retinal toxoplasmosis (PIRT) as an atypical presentation of ocular toxoplasmosis (OT).

Methods: Retrospective review of OT cases with PIRT lesions and review of the literature. We describe five cases (6 eyes).

Results: PIRT lesions were seen adjacent to active/healed toxoplasma retinochoroiditis. The appearance of PIRT was creamy yellowish-white, inner retinal, punctate, and sub-centimetric lesions. The depth of these lesions on optical coherence tomography was till the outer plexiform layer. Co-existing punctate outer retinal toxoplasmosis (PORT) was found in three eyes and recurrent retinochoroiditis in three. The fate of PIRT was resolution with minimal retinal thinning or progression to a full-thickness retinochoroiditis.

Conclusion: PIRT was noted in association with typical toxoplasma retinochoroiditis and PORT lesions, and had equal chances of resolution or progression to full-thickness lesions.

Keywords: Punctate inner retinal toxoplasmosis; ocular toxoplasmosis; punctate outer retinal toxoplasmosis; toxoplasma retinochoroiditis.