Structural Retinal and Choroidal Changes in Toxoplasmic Retinochoroiditis Assessed by Swept-Source Optical Coherence Tomography.

IF 2 4区医学 Q2 OPHTHALMOLOGY

Ocular Immunology and Inflammation Pub Date : 2026-05-07 DOI:10.1080/09273948.2026.2654782

Ramavath Sree Keerti, Manjit Boro, Muhsin Hashim, Alejandra De-La-Torre, Jyotirmay Biswas

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Abstract

Purpose: To demonstrate retinal and choroidal structural changes across distinct disease activity phases in toxoplasma retinochoroiditis (TRC) using swept-source optical coherence tomography (SS-OCT) and establishing stage-specific imaging biomarkers for therapeutic decisions and monitoring.

Methods: Retrospective analytical study of 33 patients (39 eyes) with TRC (2017-2024) at a tertiary uveitis clinic. Eyes categorized as active (n = 5), reactive (n = 13), or inactive (n = 27) using standardized clinical/serological criteria. SS-OCT measured central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), retinal layers, and vitreous changes. Interobserver reproducibility assessed via intraclass correlation coefficients (ICC). Continuous parameters compared using Kruskal-Wallis H test with Dunn's post-hoc correction. Multivariate logistic regression controlled for age, sex, lesion location, and bilaterality.

Results: Mean age 25.4 ± 16.6 years (21 M:12F), 6 bilateral cases. BCVA improved from 0.67 ± 0.58 to 0.47 ± 0.42 logMAR (p < 0.05). Active eyes showed highest CFT (median 192 μm, range 95-420 μm), SFCT (median 412 μm), posterior hyaloid thickening (100%), vitreous hyperreflective dots (80%), and intraretinal/subretinal fluid (60%). Reactive eyes had intermediate thickness, RPE hyperreflectivity (84.6%), and outer retinal atrophy (92.3%). Inactive eyes demonstrated thinning, ellipsoid zone disruption (100%), RPE loss (100%), and epiretinal membranes (81.5%). Kruskal-Wallis: CFT H = 12.4, p = 0.002; SFCT H = 9.8, p = 0.007. Serous retinal detachment 17.9% (mostly active), no recurrence. ICC > 0.85 confirmed measurement reproducibility.

Conclusions: SS-OCT reveals distinct structural signatures across TRC phases: active disease shows retinal edema and vitreoretinal disruption; reactive phases exhibit transitional remodeling; inactive disease manifests chronic atrophy. SS-OCT validates quantifiable disease staging, treatment monitoring, and prognostication. Future multimodal imaging studies needed.

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扫描源光学相干断层扫描评估弓形虫性视网膜脉络膜炎的视网膜和脉络膜结构改变。

目的：利用扫描源光学相干断层扫描（SS-OCT）研究弓形虫视网膜脉络膜炎（TRC）不同疾病活动阶段的视网膜和脉络膜结构变化，并建立阶段特异性成像生物标志物，用于治疗决策和监测。方法：回顾性分析某三级葡萄膜炎门诊33例（39眼）TRC患者的临床资料。使用标准化的临床/血清学标准将眼睛分为活动性（n = 5）、反应性（n = 13）和非活动性（n = 27）。SS-OCT测量中央中央凹厚度（CFT）、中央凹下脉络膜厚度（SFCT）、视网膜层数和玻璃体变化。通过类内相关系数（ICC）评估观察者间的可重复性。连续参数比较采用Kruskal-Wallis H检验与Dunn事后校正。多因素logistic回归控制了年龄、性别、病变部位和双侧性。结果：平均年龄25.4±16.6岁（21岁：12岁），双侧6例。BCVA从0.67±0.58 logMAR改善至0.47±0.42 logMAR （p p = 0.002; SFCT H = 9.8, p = 0.007）。浆液性视网膜脱离17.9%（多为活动性），无复发。ICC > 0.85确认测量重现性。结论：SS-OCT在TRC各阶段显示出不同的结构特征：活动性疾病表现为视网膜水肿和玻璃体视网膜破坏；反应相表现为过渡性重构；非活动性疾病表现为慢性萎缩。SS-OCT验证了可量化的疾病分期、治疗监测和预后。需要进一步的多模态成像研究。

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来源期刊

Ocular Immunology and Inflammation 医学-眼科学

CiteScore

6.20

自引率

15.20%

发文量

285

审稿时长

6-12 weeks

期刊介绍： Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.