Optical Coherence Tomography Angiography Analysis of Retinal and Choroidal Vascular Networks during Acute, Relapsing, and Quiescent Stages of Macular Toxoplasma Retinochoroiditis

Figure 3

(a–e) Active recurrent toxoplasma retinochoroiditis in a 23-yo woman who presented with a best-corrected visual acuity (BCVA) of 20/40 in her left eye and treated with pyrimethamine, azithromycin, and prednisolone. (a) Shows a yellowish active temporomacular recurrence of a toxoplasmic lesion with centripetal hyperfluorescent leakage (color picture) at the late fundus fluorescein angiography (FFA) phase (b) and hypofluorescence of the whole lesion along with other hypofluorescent satellite spots on indocyanine green angiography (ICG) (c). (d) D1–D3 show the vessel flux evolution, respectively, at initial examination (D1), at 15 days after treatment (D2), and 2 months after treatment (D3), all in the superficial retinal capillaries (yellow arrows), deep retinal capillaries (red arrows), and choriocapillary vessels (white arrows). At presentation (D1), flux seems to disappear at the center of the toxoplasmic lesion site in all superficial and deep retinal capillaries and appears to be rarefied at the toxoplasmic lesion periphery. Also, vessel flux appears to be very weak and almost not detectable in the choroid. At day 15 (D2) and two months after treatment (D3), flux seems to reappear in some superficial and deep retinal capillaries, which may be due either to difficulties encountered during segmentation or the masque effect due to the inflammatory lesion, but either way seems to remain minimal. Finally, an increase of the choroidal flux can be observed at the periphery of the lesion after treatment. (e) E1–E3 correspond, respectively, to vessel flux shown in D1, D2, and D3, but with suppression of all retinal and choroidal layers.

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