Intraocular inflammatory reactions without focal necrotizing retinochoroiditis in patients with acquired systemic toxoplasmosis

PURPOSE: To describe the occurrence of intraocular inflammatory reactions a s the sole ophthalmic manifestation of acquired systemic toxoplasmosis. METHODS: Review of medical records for 10 patients with uveitis and evidenc e of recent Toxoplasma gondii infection. RESULTS: Patient ages ranged from 3 to 51 years. Ocular symptoms were prese nt in each of eight adult patients. Inflammation was unilateral in nine pat ients; it manifested as vitreous humor cells and haze (10 patients), anteri or chamber cells (seven patients), and retinal vasculitis (seven patients). No patient had necrotizing retinochoroiditis upon initial examination. Inf lammation resolved in each of nine patients who had follow up examinations. Foci of retinitis or inactive retinochoroidal scars were seen in four of t hese nine patients during follow-up examinations, at intervals of 2.0 weeks to 2.5 years after initial examination. CONCLUSIONS: Retinal vasculitis and associated inflammatory reactions may b e the only ophthalmic disorder during the early stages of a newly acquired T. gondii infection. Later development of retinitis or scars consistent wit h toxoplasmic retinochoroiditis in the same eyes suggests that the initial, isolated inflammation may be caused by the presence of parasites in retina l tissue. These cases may have implications for understanding the original source of retinal infection in patients who have recurrent toxoplasmic reti nochoroiditis and for treatment of newly acquired T gondii infection. (Am J Ophthalmol 1999;128:413-420. (C) 1999 by Elsevier Science Inc, All rights reserved.).