Case report of post streptococcal multifocal choroiditis in a young pregnant female: A success story.

BACKGROUND: Multifocal choroiditis (MFC) is described as a chronic bilateral progressive inflammatory outer chorioretinopathy, that usually affects healthy myopic Caucasian women with no associated systemic/ocular diseases. This patient had a severe acute presentation of aggressive multifocal choroiditis that was treated with systemic steroids. CASE PRESENTATION: This is a retrospective case report of a 30-year-old, white, European, female who was 10 weeks pregnant. She had bilateral severe vision loss and rapidly progressive rash and arthritis. The patient was extensively investigated for inflammatory and infectious etiologies by a multidisciplinary team including rheumatology and obstetrics and gynecology. Antistreptolysin levels were moderately raised. Serial retinal optical coherence tomography scans were performed and were critical for assessing disease activity and demonstrating the extent of retinal and choroidal lesions. CONCLUSION: This was a challenging case as the patient was pregnant. Nevertheless, a multidisciplinary team, opted for treatment with systemic steroids which then lead to recovery of her vision.

Toxoplasmosis Related Neuroretinitis: More than Meets the Eye.

BACKGROUND: The intracellular protozoan Toxoplasma (T. gondii) is a parasitic infection, normally asymptomatic in immunocompetent patients. It often manifests ophthalmically, with focal necrotizing retinitis, and is more rarely associated with vitritis and anterior uveitis. Neuroretinitis, which results in severe, painless visual loss, optic disc edema, and a macular star, is an unusual first presentation of toxoplasmosis which despite being rare, when it does occur tends to affect young, immunosuppressed patients. CASE PRESENTATION: This case report describes a 34-year-old, white, European, immunocompetent female, who developed sudden visual loss and was found to have optic disc edema and stellate macular exudates. She was managed in an ophthalmic unit in the UK, a country with a low prevalence of toxoplasmosis Following extensive investigation, confirming Toxoplasma the standard anti-toxoplasmosis treatment was commenced, resulting in visual improvement over the following 6 months. CONCLUSION: Toxoplasmic neuroretinitis should be considered with no background of systemic illness and in the absence of classical risk factors.