Acute Acquired Ocular Toxoplasmosis-A Case Report

We presented a 58-year-old healthy male who suffered from sudden onset of blurred vision and floaters in his left eye for 6 days. In our clinic, the visual acuity of his left eye was counting finger and a solitary, yellowish white retinal necrotic lesion about one disc diameter with vitritis and anterior uveitis was noted on ocular examination. The retinal necrotic lesion was on the macula, and looked like ”headlight in the fog” due to heavy vitreous reaction. Positive results of anti-toxoplasma IgG and IgM in serum and aqueous were found. The Goldmann-Witmer coefficient (toxoplasma IgG in aqueous/toxoplasma IgG in serum: total IgG in aqueous/total IgG in serum)1 was greater than 1 (2.27), suggesting an intraocular infection. Acute acquired ocular toxoplasmosis was diagnosed, and he was treated with sulfamethoxazole/trimethoprime (baktar), clindamycin and prednisolone. The retinal necrotic lesion gradually resolved. After treatment for 10 weeks, the chorioretinitis lesion left an atrophic scar and best corrected visual acuity (BCVA) improved to 6/60. No recurrent lesion was noted during the 8-month follow-up period. Acquired ocular toxoplasmosis is seldom seen in Taiwan. Goldmann-Witmer coefficient may be an effective and specific method for the diagnosis of intraocular toxoplasmosis infection.