case_images: PMC10601836_01
case_images: Initial Presentation. a Fundus photography of OD demonstrates a hazy view with a yellow, creamy lesion near the superior arcade. b Early-phase fluorescein angiography of OD demonstrates leakage surrounding a central hypofluorescent lesion, along with leakage of the optic disc. c OD optical coherence tomography (OCT) B-scan on the lesion shows hyperreflectivity of the inner retina representing necrosis. d OCT B-scan on the macula shows subretinal and intraretinal fluid.
case_images: cop-2023-0014-0001-528787_F01.jpg
case_images: PMC10601836_01_cop-2023-0014-0001-528787_F01.jpg
case_images: F1
case_images: Fundus examination OD demonstrated vitreous haze and a superior yellow lesion (Fig. 1a). OD revealed leakage in the superior macula (Fig. 1b). Optical coherence tomography (OCT) (Heidelberg Spectralis, Heidelberg Engineering, Germany) of OD through the macular lesion revealed inner retinal hyperreflectivity and edema suggestive of retinal necrosis (Fig. 1c, d).
case_images: 9-month follow-up of OD. a Early-phase fluorescein angiography demonstrates an artery traversing through the toxoplasma lesion becoming occluded (yellow arrow) and not perfusing distally. b Fundus photography demonstrates a superior, inactive yellow toxoplasmosis lesion with an extension of whitening along the superior arcade. Note that the whitening follows the artery that traverses through the toxoplasmosis lesion. c OCT B-scan on the area of whitening demonstrates hyperreflectivity of the inner nuclear layer, representing paracentral acute middle maculopathy (PAMM). d OCT B-scan on the fovea shows resolution of the macular edema with temporal PAMM. e Fundus photography 6 months later demonstrates resolution of the whitening. f OCT B-scan on the area of whitening demonstrates resolution of PAMM with now inner retinal thinning. g OCT on the fovea shows temporal thinning corresponding to previous PAMM.
case_images: cop-2023-0014-0001-528787_F02.jpg
case_images: PMC10601836_01_cop-2023-0014-0001-528787_F02.jpg
case_images: F2
case_images: Fundus examination of OD demonstrated retinal whitening and edema along the superior arcade adjacent to an inactive retinal scar (Fig. 2a). Fluorescein angiography demonstrates an artery traversing through the toxoplasmosis lesion, with blockage of perfusion distally (Fig. 2b). OCT revealed a hyperreflective band in the inner nuclear layer around the area of whitening, sparing the fovea (Fig. 2c, d). Six months later, the en face structural SS-OCT and corresponding B-scans showed resolution of PAMM with interval development of retinal thinning (Fig. 2e-g, 3d-f).
case_images: a, b 12 x 12 mm en face structural SS-OCT demonstrates an arteriolar pattern of PAMM, with corresponding B-scan segmented in the middle retina. c 12 x 12 mm en face OCT angiography demonstrates areas of hyporeflectivity representing non-perfusion. d, e 6 months later, there is resolution of the arteriolar pattern PAMM on en face structural SS-OCT, with corresponding B-scan showing temporal thinning. f En face OCT angiography shows increased areas of non-perfusion around the affected retinal artery.
case_images: cop-2023-0014-0001-528787_F03.jpg
case_images: PMC10601836_01_cop-2023-0014-0001-528787_F03.jpg
case_images: F3
case_images: A 12 x 12 mm en face structural SS-OCT of the middle retina demonstrated paracentral acute middle maculopathy (PAMM) with non-perfusion in an arteriolar distribution (Fig. 3a-c). Six months later, the en face structural SS-OCT and corresponding B-scans showed resolution of PAMM with interval development of retinal thinning (Fig. 2e-g, 3d-f).