Disease of the year: Ocular Toxoplasmosis in HIV patients

Ocular toxoplasmosis (OT) may be an initial manifestation of acquired immunodeficiency syndrome (AIDS) in patients infected with the human immunodeficiency virus (HIV). It has different clinical manifestations and can mimic other intraocular infections. Clinical findings may show single or multifocal retinochoroidal lesions or panuveitis. Atypical presentations are associated with extensive unilateral or bilateral areas of retinal necrosis. Lesions not associated with pre-existing retinochoroidal scarring are usually due to acquired infection rather than congenital infection. When CD4+ T cell counts are <100 c/uL, vitreitis is usually mild. Isolated anterior uveitis has been reported in single cases. Positive immunoglobulin M (IgM) antibodies are rare, but their presence can support the diagnosis. As atypical presentations are common, anterior chamber aspiration for PCR of infectious DNA should be considered, as early diagnosis and treatment can prevent massive tissue destruction and preserve vision. This review provides an overview of OT in HIV-infected patients.

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