Estudo morfológico das alterações vitreorretinianas em pacientes com retinocoroidite supostamente causada pelo toxoplasma gondii. Estudo prospectivo pela tomografia de coerência óptica.

Abstract

Ocular toxoplasmosis is one of the leading causes of uveitis, especially in Brazil, typically characterized by focal necrotizing retinochoroiditis with vitritis and adjacent retinochoroiditis scarring. Another form of presentation is punctate external retinitis. Diagnosis is primarily clinical, based on the characteristics of the lesion and the inflammation, with optical coherence tomography (OCT 3) being a crucial method to assess the affected structures and complications at the vitreoretinal interface.

The study was conducted at Hospital São Geraldo, Minas Gerais, with the objective of evaluating vitreoretinal changes in patients with active retinochoroiditis associated with *Toxoplasma gondii*, using clinical examination, color retinography, and OCT, in addition to monitoring changes during the healing process.

The study involved 15 eyes, classified into three clinical forms: punctate external, focal, and satellite. The follow-up included retinography and OCT every two weeks, with additional examinations after 12 and 24 weeks. During the active phase, lesions showed increased reflectivity in the inner retinal layers with optical shadowing of the underlying retina-choriocapillaris/choroid complex (RPE-cc/C). The punctate external form showed reduced retinal thickness, while the focal and satellite forms showed increased thickness. The posterior hyaloid membrane was thickened and detached over the lesions in some cases.

The study demonstrated that OCT 3 was effective in identifying inflammatory and scarring characteristics, including macular changes that were not clinically visible, such as macular edema and vitreofoveal traction. It concludes that OCT 3 is a valuable tool in the evaluation and follow-up of ocular toxoplasmosis, providing detailed information on the different forms of retinochoroiditis.