Single Acquisition of the Vitreous, Retina and Choroid With Swept-Source Optical Coherence Tomography in Acute Toxoplasmosis

In Brief Background/Purpose: To report the swept-source optical coherence tomography (SS-OCT) findings in a case of acute toxoplasmosis chorioretinitis. Methods: A 35-year-old male presented with acute blurry vision and floaters in his left eye. Ophthalmic examination, color photographs, spectral-domain OCT (SD-OCT), enhanced depth imaging OCT (EDI-OCT), SS-OCT and wide-field fluorescein angiography images were obtained to diagnose and follow the subsequent changes of toxoplasmosis chorioretinitis over a 2-month period. Results: Initial imaging with different modalities of SD- and EDI-OCT including radial vitreous scans and horizontal high-speed B-scan raster lines demonstrated thickening of the posterior hyaloid and acute vitreous cells emanating from the retinal blood vessels, thickening and disorganization of the retinal layers within the chorioretinal lesion, and increased sub-lesional choroidal thickness, respectively. SS-OCT demonstrated all of these same findings in a single 12-mm B-scan. Topical steroids were initiated and imaging over the next 2 months showed separation of the posterior hyaloid, decrease in vitreous cell, and atrophy of the chorioretinal lesion. Conclusion: We report the first SS-OCT images of an acute case of toxoplasmosis chorioretinitis. SS-OCT can visualize the choroidal, retinal, and vitreous changes in a single scan, compared with the different imaging algorithms required with SD-OCT. Swept-source optical coherence tomography (SS-OCT) is an efficient imaging method in analyzing the choroid, retina, and vitreous in a single scan. Herein, the authors present a case of a 35-year-old man with active ocular toxoplasmosis and compare spectral-domain to SS-OCT findings at presentation and resolution.