title: Macular hole secondary to toxoplasmic retinochoroiditis.
abstract: Ocular toxoplasmosis causes abnormalities in the vitreous that are responsible for several types of well-known complications including retinal detachment and epiretinal membranes. We report on a patient who developed toxoplasmic panuveitis with a full-thickness macular hole (MH) and was successfully treated with vitreoretinal surgery. A 35-year-old Hispanic female presented with a 2-week history of loss of visual acuity and metamorphopsia in her right eye. Funduscopy revealed a typical toxoplasmosis lesion and a MH, which was confirmed by optical coherence tomography. After 8 weeks of medical treatment with sulfamethoxazole (800 mg)/trimethoprim (160 mg) and steroids, the intraocular inflammation was considered inactive. Pars plana vitrectomy with inner limiting membrane peeling and injection of 24 % sulphur hexafluoride gas were performed to treat the MH, without success. Repeat pars plana vitrectomy was then performed with injection of 14 % perfluoropropane (C3F8). Closure of the MH was achieved after this second procedure. Vitreoretinal surgery may be safe and effective for treating MHs secondary to toxoplasmosis lesions, a very uncommon complication of this disease.
authors.affiliation: Department of Ophthalmology, BioCruces Health Research Institute, Cruces Hospital, University of the Basque Country, Bilbao, Spain.
authors.forename: Begoña
authors.initials: B
authors.lastname: Arana
authors.forename: Alex
authors.initials: A
authors.lastname: Fonollosa
authors.forename: Joseba
authors.initials: J
authors.lastname: Artaraz
authors.forename: Agustin
authors.initials: A
authors.lastname: Martinez-Berriotxoa
authors.forename: Nerea
authors.initials: N
authors.lastname: Martinez-Alday
mesh_terms: D000328:Adult; D002825:Chorioretinitis / Q000469:parasitology*; D005260:Female; D006801:Humans; D012167:Retinal Perforations / Q000209:etiology*; D014126:Toxoplasmosis, Ocular / Q000150:complications*; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods