title: Fulminant toxoplasmic retinochoroiditis following intravitreal triamcinolone administration.
abstract: We report two cases of fulminant toxoplasmic retinochoroiditis following intravitreal triamcinolone acetonide (IVTA) administration. Case 1: A 42-year-old female received IVTA for presumed non-infectious panuveitis. Within 2 months, she developed diffuse macular retinochoroiditis with optic disc edema. Upon starting anti-toxoplasmic therapy (ATT), her intraocular inflammation resolved with catastrophic damage to the disc and macula. Case 2: A 30-year-old male received IVTA for presumed reactivation of previously scarred toxoplasmic retinochoroiditis. Despite simultaneous ATT, within 6 weeks, he developed extensive, multifocal macular retinochoroiditis. He continued to require ATT for 18 months and later underwent vitrectomy with silicone oil placement for severe epiretinal proliferation. Aqueous tap polymerase chain reactions were found positive for Toxoplasma gondii in both cases. In conclusion, IVTA administration can lead to fulminant toxoplasmic retinochoroiditis even when used with appropriate ATT. Extreme caution should be exercised while administering depot corticosteroids in eyes with panuveitis of unknown origin.
authors.affiliation: Bascom Palmer Eye Institute, Miami, Florida, United States of America.
authors.forename: Ryan
authors.initials: R
authors.lastname: Rush
authors.forename: Saumil
authors.initials: S
authors.lastname: Sheth
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D002833:Choroiditis / Q000209:etiology* / Q000469:parasitology; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D009894:Opportunistic Infections / Q000209:etiology* / Q000469:parasitology; D015864:Panuveitis / Q000188:drug therapy*; D012173:Retinitis / Q000209:etiology* / Q000469:parasitology; D014123:Toxoplasmosis / Q000209:etiology*; D014222:Triamcinolone Acetonide / Q000009:adverse effects*
chemical_list: D000893:Anti-Inflammatory Agents; D014222:Triamcinolone Acetonide