PMC7268411_01
Slit lamp photograph of patient one shows the sub-Tenons triamcinolone acetonide (Kenalog) prior to the development of severe chorioretinitis (a). Histopathologic analysis showing toxoplasmosis bradyzoites at 250 x magnification (b, arrows). Color fundus photo montage of patient one shows a hazy view secondary to vitritis, disc edema, and patchy retinal whitening (c). While the vitreous inflammation and retinal whitening has improved, optic nerve pallor and retinal vascular attenuation are observed (d)
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Fig1
Slit lamp exam demonstrated a triamcinolone depot in the inferior fornix (Fig. 1) and 2+ anterior chamber cell and vitreous cell in the left eye. Histopathologic analysis showed bradyzoites consistent with toxoplasmosis (Fig. 1).
PMC7268411_02
Color fundus photo montage of the left eye of patient two shows diffuse retinal whitening involving the posterior pole and severe vascular attenuation (a). With oral and intravitreal anti-parasitic medication, the majority of the retinitis has improved but optic nerve pallor, diffuse retinal pigment epithelial atrophy and severe vascular attenuation are seen (b)
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Fig2
Funduscopic exam demonstrated retinitis involving the posterior pole of the left eye (Fig. 2).
PMC7268411_03
Color fundus photo montage of the right eye of patient three demonstrates a hazy view secondary to vitritis and diffuse, fulminant retinal necrosis (a). Following anti-toxoplasmosis therapy and retinal detachment repair, the retina is attached although there is severe vascular attenuation, optic nerve pallor, and fibrosis with chorioretinal scarring superonasally (b)
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Fig3
While awaiting PCR testing results, the retinitis had continued to worsen with intravitreal foscarnet and ganciclovir injections (Fig. 3). The patient's retinitis remained inactive, but her vision remained hand motions at 18-month follow-up (Fig. 3).