Central retinal artery occlusion during convalescence from systemic acute toxoplasmosis

A 37-year-old woman developed visual loss in the left eye for 2 months. She was diagnosed with central retinal artery occlusion with diffuse retinal whitening, disk pallor, and arterial attenuation. Optical coherence tomography showed hyperreflectivity and thinning of the inner retinal layers [Fig. 1]. She had recovered from an acute febrile illness 1 month before her ocular symptoms. Blood tests during febrile illness had shown very high levels of Toxoplasma immunoglobulin G (IgG) (>300; reference laboratory range <4.0) and a positive immunoglobulin M (IgM) (0.75; reference laboratory range <0.55) and were treated with oral co-trimoxazole. She did not have hypertension, diabetes, and/or additional cardiovascular risk factors. Central retinal artery occlusion during convalescence from acute systemic toxoplasmosis was a rare association in this case.Figure 1: (a) Widefield fundus photograph showing mild disk pallor, diffuse arterial attenuation, and retinal whitening suggestive of central retinal artery occlusion. No signs of intraocular inflammation were seen. (b) An optical coherence tomography showing hyperreflectivity and thinning of the inner retinal layers in this case of central retinal artery occlusion (CRAO). This horizontal scan corresponds to the area shown on the white arrow in the inset fundus image. The central subfield thickness of the left eye was 182 µmDeclaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: This study was supported by the Hyderabad Eye Research Foundation, Hyderabad. Conflicts of interest: There are no conflicts of interest.