Toxoplasmosis retinochoroiditis after photodynamic therapy and intravitreal triamcinolone for a supposed choroidal neovascularization: a case report.
The purpose is to report a complication after photodynamic therapy (PDT) and intravitreal triamcinolone for a presumed choroidal neovascularization in age-related macular degeneration. Photodynamic therapy and intravitreal triamcinolone were used in an 84-year-old man with choroidal neovascularization in the left eye. Forty-five days after therapy, the patient returned with a severe necrotizing uveitis in the posterior pole and vitritis. Laboratory investigation disclosed a high anti-Toxoplasma IgG titer. Therapy with pyrimethamine, sulfadiazine and folinic acid resulted in total lesion healing although central vision was lost. Intravitreal triamcinolone may have had an influence on the exacerbation of retinochoroiditis in the posterior pole of the patient. Although rare, this complication may not be disregarded in the cases that require intraocular corticosteroids for treatment of several conditions, especially in patients who had previously suffered from toxoplasmosis infection.
Nóbrega
Mário Junqueira
MJ
Universidade Federal de São Paulo, São Paulo, SP, Brazil. mjn@terra.com.br
Rosa
Evandro Luís
EL
D000369:Aged, 80 and over; D002825:Chorioretinitis / Q000188:drug therapy / Q000209:etiology*; D020256:Choroidal Neovascularization / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D010778:Photochemotherapy / Q000009:adverse effects*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D011166:Porphyrins / Q000008:administration & dosage; D012720:Severity of Illness Index; D014126:Toxoplasmosis, Ocular / Q000188:drug therapy / Q000209:etiology*; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000009:adverse effects*; D000077362:Verteporfin; D014792:Visual Acuity
D005938:Glucocorticoids; D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin; D014222:Triamcinolone Acetonide