Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Atypical, severe toxoplasmic retinochoroiditis in elderly patients.

Publication ,  Journal Article
Johnson, MW; Greven, GM; Jaffe, GJ; Sudhalkar, H; Vine, AK
Published in: Ophthalmology
January 1997

BACKGROUND: The diagnosis of toxoplasmic retinochoroiditis is based primarily on characteristic ocular findings, with supportive serologic evidence. Clinical recognition of atypical presentations is critical for timely antiparasitic drug therapy. METHODS: Case histories were reviewed for seven presumed immunocompetent elderly patients with atypically severe (multifocal or diffuse or both) toxoplasmic retinochoroiditis. Three cases initially were misdiagnosed as acute retinal necrosis syndrome. The correct diagnosis was confirmed in each case by response to antiparasitic drug therapy, polymerase chain reaction studies of intraocular specimens, or histopathologic analysis. RESULTS: The patients ranged in age from 69 to 82 years (median, 74 years). Only three patients had intercurrent medical conditions that may be associated with subtle immune dysfunction (diabetes mellitus and hepatitis C). The extensive necrotizing retinochoroiditis in each patient was nonhemorrhagic and not associated with occlusive retinal arteritis. Despite prompt response to antiparasitic drug therapy, prolonged treatment usually was required, and four patients had retinitis reactivation after discontinuing treatment. Significant visual loss accompanied the infection in most eyes. CONCLUSION: Toxoplasmosis should be considered as a cause of multifocal or diffuse necrotizing retinitis or both in elderly patients. Older patients may be more susceptible to severe ocular Toxoplasma infections because of age-related decline in cell-mediated immunity and chronic underlying diseases.

Duke Scholars

Published In

Ophthalmology

DOI

ISSN

0161-6420

Publication Date

January 1997

Volume

104

Issue

1

Start / End Page

48 / 57

Location

United States

Related Subject Headings

  • Visual Acuity
  • Toxoplasmosis, Ocular
  • Toxoplasma
  • Retinal Necrosis Syndrome, Acute
  • Ophthalmology & Optometry
  • Male
  • Humans
  • Glucocorticoids
  • Female
  • Diagnosis, Differential
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Johnson, M. W., Greven, G. M., Jaffe, G. J., Sudhalkar, H., & Vine, A. K. (1997). Atypical, severe toxoplasmic retinochoroiditis in elderly patients. Ophthalmology, 104(1), 48–57. https://doi.org/10.1016/s0161-6420(97)30362-5
Johnson, M. W., G. M. Greven, G. J. Jaffe, H. Sudhalkar, and A. K. Vine. “Atypical, severe toxoplasmic retinochoroiditis in elderly patients.Ophthalmology 104, no. 1 (January 1997): 48–57. https://doi.org/10.1016/s0161-6420(97)30362-5.
Johnson MW, Greven GM, Jaffe GJ, Sudhalkar H, Vine AK. Atypical, severe toxoplasmic retinochoroiditis in elderly patients. Ophthalmology. 1997 Jan;104(1):48–57.
Johnson, M. W., et al. “Atypical, severe toxoplasmic retinochoroiditis in elderly patients.Ophthalmology, vol. 104, no. 1, Jan. 1997, pp. 48–57. Pubmed, doi:10.1016/s0161-6420(97)30362-5.
Johnson MW, Greven GM, Jaffe GJ, Sudhalkar H, Vine AK. Atypical, severe toxoplasmic retinochoroiditis in elderly patients. Ophthalmology. 1997 Jan;104(1):48–57.
Journal cover image

Published In

Ophthalmology

DOI

ISSN

0161-6420

Publication Date

January 1997

Volume

104

Issue

1

Start / End Page

48 / 57

Location

United States

Related Subject Headings

  • Visual Acuity
  • Toxoplasmosis, Ocular
  • Toxoplasma
  • Retinal Necrosis Syndrome, Acute
  • Ophthalmology & Optometry
  • Male
  • Humans
  • Glucocorticoids
  • Female
  • Diagnosis, Differential