DR. HEMA V.K

DR. GEORGE J. MANAYATH

Abstract

A 23-year-old man who was diagnosed as an idiopathic macular hole (MH) in his right eye , was referred to us for surgery. Optical coherence tomography showed full thickness MH with ill defined ragged margin surrounded by greyish discolouration of retina. Suspecting an inflammatory pathology ,we retrospectively revisited the OCT that showed cells in posterior vitreous phase. Fundus fluorescence angiography and indocyanine green angiography showed retinochoroiditis with choroidal ischemia. Blood investigation showed high IgG Toxo antibody. We treated the patient with Bactrim tablet & oral steroid. Inflammation started resolving. No surgery was done as fundus flourescene angiography revealed macular ischaemic. Presenting this case ,as toxoplasmosis manifesting as isolalated macular hole is rare. Vitreoretinal surgeons should overlook cases diagnosed as idiopathic macular hole for signs of uveitis before planning for surgery especially in absence of classical macular hole configuration.