Imaging of congenital toxoplasmosis macular scars with optical coherence tomography

PURPOSE: The purpose of this study is to document the appearance of macular toxoplasmosis scars with the high-resolution cross-sectional retinal imaging technique of optical coherence tomography (OCT) and investigate whether a correlation exists between the morphology of the toxoplasmosis scars, the OCT images, and visual acuity. METHODS: In this retrospective observational case series, fundus photos were taken of the macular lesions that were also documented by OCT. Photos were digitized for the purpose of sizing lesions. All images were classified by the authors. RESULTS: There were 10 consecutive patients (13 eyes) whose average age is 13.0 years. Macular lesions ranged from 1.6 mm to 20.2 mm. OCT features included retinal thinning, retinal pigment epithelial hyperreflectivity, excavation, intraretinal cysts, and fibrosis. Patients with better than expected vision had either parafoveal lesions or an intact neurosensory layer. CONCLUSION: The most characteristic OCT features in this young population were prominent retinal thinning, retinal pigment epithelium hyperreflectivity, and excavation of varying severity. OCT imaging is helpful in explaining better than expected vision.