Review for disease of the year: differential diagnosis of ocular toxoplasmosis.

Daniel Vitor Vasconcelos-Santos, Emilio M Dodds, Fernando Oréfice

Journal: Ocular immunology and inflammation 2011;19(3):171-9

PMID: 21595533

Abstract

The diagnosis of ocular toxoplasmosis is mainly clinical, based in the presence of focal necrotizing retinochoroiditis often associated with a preexistent chorioretinal scar, and variable involvement of the vitreous, retinal blood vessels, optic nerve, and anterior segment of the eye. Recognition of this clinical spectrum of toxoplasmic retinochoroiditis is crucial, but other infectious, noninfectious, and neoplastic entities should also be considered in the differential diagnosis. Investigations such as serological tests, polymerase chain reaction of ocular fluids, and assessment of intraocular antibody synthesis are helpful in uncertain cases. This article provides an overview of the differential diagnosis of ocular toxoplasmosis, focusing on the most important entities to be considered and emphasizing distinctive features of each one of them in the clinical setting. Ocular toxoplasmosis has multiple clinical manifestations, which partially overlap with those of other entities and these should be carefully considered when making the differential diagnosis, particularly in less typical cases.

Address: Uveitis Division, Centro Brasileiro de Ciências Visuais, Belo Horizonte, Brazil. [email protected]

DOI: 10.3109/09273948.2011.581407

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MeSH Terms: Chorioretinitis, Diagnosis, Differential, Endophthalmitis, Eye Infections, Bacterial, Eye Infections, Fungal, Eye Neoplasms, Herpes Simplex, Herpes Zoster, Humans, Lymphoma, Macula Lutea, Retinal Diseases, Retinal Necrosis Syndrome, Acute, Retinal Neoplasms, Retinitis, Syphilis, Toxoplasmosis, Ocular, Tuberculosis, Ocular, Uveitis, Posterior, Vitreous Body