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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Management of the neovascular choroidal membrane secondary to ocular toxoplasmos...
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Vol. 95. Issue 2.
Pages 90-93 (February 2020)
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Vol. 95. Issue 2.
Pages 90-93 (February 2020)
Short communication
Management of the neovascular choroidal membrane secondary to ocular toxoplasmosis
Manejo de la membrana neovascular coroidea secundaria a toxoplasmosis ocular
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5
E. Martín García
Corresponding author
elisabetmaga@gmail.com

Corresponding author.
, J.J. Chávarri García, L. Rodríguez Vicente, B. Jiménez del Río, S.M. Guallar Leza, J.L. del Río Mayor
Servicio de Oftalmología, Hospital San Pedro, Logroño, La Rioja, Spain
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Abstract

A 12-year-old patient diagnosed with congenital toxoplasmosis, with no systemic treatment at the time, who presented with a decreased visual acuity (VA) in his left eye (LE). On examination, VA in the LE was 0.05 and the fundus examination revealed a focus of chorioretinitis adjacent to a pigmented macular scar, as well as a large associated subretinal haemorrhage. After confirming the diagnosis of choroidal neovascular membrane secondary to ocular toxoplasmosis, treatment was started with systemic anti-toxoplasmosis drugs and two anti-VEGF intravitreal injections separated by one month. Finally, the patients had a VA in OI of 0.4, with reabsorption of the haemorrhage, leaving an inactive pigmented macular scar. The use of anti-VEGF intravitreal injections in cases of ocular toxoplasmosis has been associated with a reactivation of old lesions, so the prophylactic use of oral anti-toxoplasmosis drugs is recommended in these cases.

Keywords:
Toxoplasmosis
Scar
Neovascular membrane
Anti-VEGF
Treatment
Resumen

Paciente de 12 años diagnosticado de toxoplamosis congénita sin tratamiento sistémico en el momento actual que acude por disminución de agudeza visual (AV) por su ojo izquierdo (OI). A la exploración se objetiva una AV en su OI de 0,05 y al examen funduscópico un foco de coriorretinitis adyacente a una cicatriz macular pigmentada y una gran hemorragia subretiniana asociada. Tras confirmar el dignóstico de membrana neovascular coroidea (NVC) secundaria a toxoplasmosis ocular, se inicia tratamiento con fármacos antitoxoplásmicos sistémicos y dos dosis de AntiVEGF intravitreos separadas por un mes de diferencia. Finalmente, alcanza una AV en OI de 0,4 y se logra una reabsoción de la hemorragia quedando una cicatriz pigmentada macular inactiva. El uso de AntiVEGF intravitreos en cuadros de toxoplasmosis ocular se han asociado a la reactivación de antiguas lesiones, por lo que se recomienda el uso profiláctico de fármacos antitoxoplásmicos orales en estos casos.

Palabras clave:
Toxoplasmosis
Cicatriz
Membrana neovascular
Anti-VEGF
Tratamiento

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