Unilateral vitritis in an immunocompetent individual - A rare presentation of ocular toxoplasmosis

Abstract

Ocular toxoplasmosis is the leading cause of infectious retinochoroiditis in both adults and children. It is caused by the obligate intracellular parasite, Toxoplasma gondii. It is a common cause of posterior uveitis and focal retinitis, typically seen in immunocompetent individuals as a primary infection or in immunocompromised individuals as reactivation of latent infection. Here, we report a rare case of a 29-year-old immunocompetent female presenting with gradual, painless diminution of vision in the left eye associated with headache for over one month. She had a history of hypertension but no other significant medical history. On ocular examination anterior segment was unremarkable and fundus examination of left eye showed "Headlight in fog appearance" suggestive of vitritis. Serological evaluation revealed positive for Toxoplasma IgG antibodies. The patient was treated with cotrimoxazole, oral prednisolone, and topical steroids for 4-6 weeks. Following treatment, her visual acuity improved to 6/6 in left eye. This case highlights the importance of considering ocular toxoplasmosis in the differential diagnosis of unilateral vitritis, even in immunocompetent patients.