Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis

Autores
Rudzinski, Marcelo Nicolas; Cortalezzi, Juan; Erhard, Margarita; Racca, Lourdes; Couto, Cristóbal
Año de publicación
2026
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Purpose: To report the occurrence and pathological confirmation of a granuloma within an epiretinal membrane (ERM) with Toxoplasma gondii tachyzoites in a patient with recurrent retinochoroiditis. Case description: A 54-year-old female patient presented to ophthalmic consultation with decreased visual acuity (VA) and myodesopsia in the right eye (OD). She reported a history of recurrent ocular toxoplasmosis in the OD, treated with sequential courses of oral Folate synthesis inhibitors and anti-inflammatory therapy. Best corrected VA (BCVA) at initial examination was 20/400 in OD and 20/20 in OS. Fundus examination in OD revealed multiple white retinal lesions, superior to the superior temporal vessels, and temporal to the macula. OCT of the macular area showed cystoid macular edema and a thick ERM. The patient was initiated on TMP-SMX (160 mg/ 800 mg/day), azithromycin (250 mg/day), meprednisone (40 mg/day) and folinic acid. The BCVA improved to 20/40 after 45 days of treatment. Following initial treatment suspension, the BCVA decreased to 20/60. Given the extent of retinal fibrosis and architectural disruption of the retina by ERMs a vitrectomy was scheduled. ERMs were successfully peeled, and silicone tamponade was performed. Pathology results revealed the presence of a granuloma within the ERM. Immunohistochemistry confirmed the presence of T. gondii tachyzoites within the granuloma. Conclusion: The presence of T. gondii organisms within a granuloma confined to the ERM may have biological and therapeutic implications. ERM may act as a barrier, protecting the parasite from systemically delivered drugs that rely on vascular access to the lesion.
Fil: Rudzinski, Marcelo Nicolas. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Catolica de Las Misiones. Facultad de Cs. de la Salud; Argentina
Fil: Cortalezzi, Juan. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina
Fil: Erhard, Margarita. Centro de Ojos Alem; Argentina
Fil: Racca, Lourdes. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina
Fil: Couto, Cristóbal. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina
Materia
Ocular Toxoplasmosis
Retinochoroiditis
Epiretinal membrane
Granuloma
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/286590
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/286590
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosisRudzinski, Marcelo NicolasCortalezzi, JuanErhard, MargaritaRacca, LourdesCouto, CristóbalOcular ToxoplasmosisRetinochoroiditisEpiretinal membraneGranulomahttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Purpose: To report the occurrence and pathological confirmation of a granuloma within an epiretinal membrane (ERM) with Toxoplasma gondii tachyzoites in a patient with recurrent retinochoroiditis. Case description: A 54-year-old female patient presented to ophthalmic consultation with decreased visual acuity (VA) and myodesopsia in the right eye (OD). She reported a history of recurrent ocular toxoplasmosis in the OD, treated with sequential courses of oral Folate synthesis inhibitors and anti-inflammatory therapy. Best corrected VA (BCVA) at initial examination was 20/400 in OD and 20/20 in OS. Fundus examination in OD revealed multiple white retinal lesions, superior to the superior temporal vessels, and temporal to the macula. OCT of the macular area showed cystoid macular edema and a thick ERM. The patient was initiated on TMP-SMX (160 mg/ 800 mg/day), azithromycin (250 mg/day), meprednisone (40 mg/day) and folinic acid. The BCVA improved to 20/40 after 45 days of treatment. Following initial treatment suspension, the BCVA decreased to 20/60. Given the extent of retinal fibrosis and architectural disruption of the retina by ERMs a vitrectomy was scheduled. ERMs were successfully peeled, and silicone tamponade was performed. Pathology results revealed the presence of a granuloma within the ERM. Immunohistochemistry confirmed the presence of T. gondii tachyzoites within the granuloma. Conclusion: The presence of T. gondii organisms within a granuloma confined to the ERM may have biological and therapeutic implications. ERM may act as a barrier, protecting the parasite from systemically delivered drugs that rely on vascular access to the lesion.Fil: Rudzinski, Marcelo Nicolas. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Catolica de Las Misiones. Facultad de Cs. de la Salud; ArgentinaFil: Cortalezzi, Juan. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Erhard, Margarita. Centro de Ojos Alem; ArgentinaFil: Racca, Lourdes. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Couto, Cristóbal. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaElsevier2026-06info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/286590Rudzinski, Marcelo Nicolas; Cortalezzi, Juan; Erhard, Margarita; Racca, Lourdes; Couto, Cristóbal; Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis; Elsevier; American Journal of Ophthalmology Case Reports; 42; 102575; 6-2026; 1-42451-9936CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/pii/S2451993626000630info:eu-repo/semantics/altIdentifier/doi/10.1016/j.ajoc.2026.102575info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-nd/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-06-17T09:45:18Zoai:ri.conicet.gov.ar:11336/286590instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-06-17 09:45:18.37CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis
title Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis
spellingShingle Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis
Rudzinski, Marcelo Nicolas
Ocular Toxoplasmosis
Retinochoroiditis
Epiretinal membrane
Granuloma
title_short Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis
title_full Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis
title_fullStr Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis
title_full_unstemmed Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis
title_sort Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis
dc.creator.none.fl_str_mv Rudzinski, Marcelo Nicolas
Cortalezzi, Juan
Erhard, Margarita
Racca, Lourdes
Couto, Cristóbal
author Rudzinski, Marcelo Nicolas
author_facet Rudzinski, Marcelo Nicolas
Cortalezzi, Juan
Erhard, Margarita
Racca, Lourdes
Couto, Cristóbal
author_role author
author2 Cortalezzi, Juan
Erhard, Margarita
Racca, Lourdes
Couto, Cristóbal
author2_role author
author
author
author
dc.subject.none.fl_str_mv Ocular Toxoplasmosis
Retinochoroiditis
Epiretinal membrane
Granuloma
topic Ocular Toxoplasmosis
Retinochoroiditis
Epiretinal membrane
Granuloma
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Purpose: To report the occurrence and pathological confirmation of a granuloma within an epiretinal membrane (ERM) with Toxoplasma gondii tachyzoites in a patient with recurrent retinochoroiditis. Case description: A 54-year-old female patient presented to ophthalmic consultation with decreased visual acuity (VA) and myodesopsia in the right eye (OD). She reported a history of recurrent ocular toxoplasmosis in the OD, treated with sequential courses of oral Folate synthesis inhibitors and anti-inflammatory therapy. Best corrected VA (BCVA) at initial examination was 20/400 in OD and 20/20 in OS. Fundus examination in OD revealed multiple white retinal lesions, superior to the superior temporal vessels, and temporal to the macula. OCT of the macular area showed cystoid macular edema and a thick ERM. The patient was initiated on TMP-SMX (160 mg/ 800 mg/day), azithromycin (250 mg/day), meprednisone (40 mg/day) and folinic acid. The BCVA improved to 20/40 after 45 days of treatment. Following initial treatment suspension, the BCVA decreased to 20/60. Given the extent of retinal fibrosis and architectural disruption of the retina by ERMs a vitrectomy was scheduled. ERMs were successfully peeled, and silicone tamponade was performed. Pathology results revealed the presence of a granuloma within the ERM. Immunohistochemistry confirmed the presence of T. gondii tachyzoites within the granuloma. Conclusion: The presence of T. gondii organisms within a granuloma confined to the ERM may have biological and therapeutic implications. ERM may act as a barrier, protecting the parasite from systemically delivered drugs that rely on vascular access to the lesion.
Fil: Rudzinski, Marcelo Nicolas. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Catolica de Las Misiones. Facultad de Cs. de la Salud; Argentina
Fil: Cortalezzi, Juan. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina
Fil: Erhard, Margarita. Centro de Ojos Alem; Argentina
Fil: Racca, Lourdes. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina
Fil: Couto, Cristóbal. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina
description Purpose: To report the occurrence and pathological confirmation of a granuloma within an epiretinal membrane (ERM) with Toxoplasma gondii tachyzoites in a patient with recurrent retinochoroiditis. Case description: A 54-year-old female patient presented to ophthalmic consultation with decreased visual acuity (VA) and myodesopsia in the right eye (OD). She reported a history of recurrent ocular toxoplasmosis in the OD, treated with sequential courses of oral Folate synthesis inhibitors and anti-inflammatory therapy. Best corrected VA (BCVA) at initial examination was 20/400 in OD and 20/20 in OS. Fundus examination in OD revealed multiple white retinal lesions, superior to the superior temporal vessels, and temporal to the macula. OCT of the macular area showed cystoid macular edema and a thick ERM. The patient was initiated on TMP-SMX (160 mg/ 800 mg/day), azithromycin (250 mg/day), meprednisone (40 mg/day) and folinic acid. The BCVA improved to 20/40 after 45 days of treatment. Following initial treatment suspension, the BCVA decreased to 20/60. Given the extent of retinal fibrosis and architectural disruption of the retina by ERMs a vitrectomy was scheduled. ERMs were successfully peeled, and silicone tamponade was performed. Pathology results revealed the presence of a granuloma within the ERM. Immunohistochemistry confirmed the presence of T. gondii tachyzoites within the granuloma. Conclusion: The presence of T. gondii organisms within a granuloma confined to the ERM may have biological and therapeutic implications. ERM may act as a barrier, protecting the parasite from systemically delivered drugs that rely on vascular access to the lesion.
publishDate 2026
dc.date.none.fl_str_mv 2026-06
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/286590
Rudzinski, Marcelo Nicolas; Cortalezzi, Juan; Erhard, Margarita; Racca, Lourdes; Couto, Cristóbal; Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis; Elsevier; American Journal of Ophthalmology Case Reports; 42; 102575; 6-2026; 1-4
2451-9936
CONICET Digital
CONICET
url http://hdl.handle.net/11336/286590
identifier_str_mv Rudzinski, Marcelo Nicolas; Cortalezzi, Juan; Erhard, Margarita; Racca, Lourdes; Couto, Cristóbal; Toxoplasmic granuloma within an epiretinal membrane in a patient with recurrent ocular toxoplasmosis; Elsevier; American Journal of Ophthalmology Case Reports; 42; 102575; 6-2026; 1-4
2451-9936
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/pii/S2451993626000630
info:eu-repo/semantics/altIdentifier/doi/10.1016/j.ajoc.2026.102575
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-nd/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.040872

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