Toxoplasmic retinochoroiditis in patients with AIDS and neurotoxoplasmosis

Purpose: Neurotoxoplasmosis is the most common central nervous system disorder in patients with AIDS. The occurrence of ocular toxoplasmosis in neurotoxoplasmosis is not well studied. The objective of this study was to investigate the occurrence of typical or probable toxoplasmic retinochoroiditis in patients with AIDS and neurotoxoplasmosis. Methods: A prospective case series was performed, including 70 patients of both genders, aged from 20 to 63 years, hospitalized in three public hospitals in Recife, Pernambuco, with such diagnosis according to the CDC criteria (1992), from January to October, 2008. Results: Patients were characterized by first neurotoxoplasmosis episode (65, 92.9%) or relapse (5, 7.1%), ignorance of AIDS diagnosis (23, 32.9%), mean CD4 T lymphocytes count of 139.8 +/- 3.04 cells/mm(3) and mean viral load of 137,080 +/- 39,380 copies/mL. All patients underwent ophthalmologic examination, consisting of ocular inspection, visual acuity measurement, investigation of ocular extrinsic muscle function and fundoscopy, using binocular indirect ophthalmoscope (model OHN 3.5 (Eyetec (R)) and 20 diopters external lens (Volk (R)). Four (5.7%) patients presented retinochoroiditis scar lesions, characteristic of ocular toxoplasmosis, typical in 3 (75%) of them and bilateral in one. There was no case of typical or probable active retinochoroiditis. Active ocular lesions were rare compared to scarring, which are associated with the presence of retinal cysts. Conclusion: Scarring lesions should be valued in patients with AIDS.