Atypical toxoplasmosis masquerading late occurrence of typical findings

PURPOSE. To report two unusual cases of ocular toxoplasmosis. METHODS. Case series. RESULTS. We describe one case of retinochoroiditis associated with branch retinal artery occlusion and a second case of optic disc edema with subsequent neuroretinitis. In both cases, the typical findings of ocular toxoplasmosis were not initially present, but became evident later during follow-up after the institution of antitoxoplasma treatment. The prompt response to antiparasitic treatment with visual improvement and late disclosure of typical findings confirmed the clinical suspicion of the diagnosis. CONCLUSIONS. Ocular toxoplasmosis must be considered in the differential diagnosis of patients with unilateral branch retinal artery occlusion and neuroretinitis. Prompt initiation of specific antibiotic treatment can improve visual prognosis and reduce ocular complications. (Eur J Ophthalmol 2009, 19: 1091-3)