Chorioretinal Biopsy-Proven Ocular Sarcoidosis in a Patient with a History of B-Cell Lymphoma

The purpose of this report is to describe biopsy-proven ocular sarcoidosis (OS) in a 67-year-old patient with a history of sarcoidosis and diffuse large B-cell lymphoma (DLBCL). Nonspecific posterior chorioretinal lesions in a patient with prior malignancy necessitated chorioretinal biopsy to rule out metastatic lymphoma. The association between sarcoidosis and malignancy remains unclear and can complicate management of similar patients with nonspecific posterior segment findings. Chorioretinal biopsy may, therefore, be required to rule out malignancy in patients with a leading history.

Ocular Toxoplasmosis Mimicking Choroidal Metastasis From Colorectal Adenocarcinoma

Purpose: The purpose of this article is to describe a case of Toxoplasma gondii chorioretinal granuloma mimicking a choroidal metastasis from colorectal adenocarcinoma. Methods: Evaluation included clinical examination with multimodal imaging techniques and chorioretinal biopsy. Results: A 37-year-old white male with a history of colorectal adenocarcinoma presented with painless vision loss in the right eye, and fundoscopic examination revealed an amelanotic choroidal lesion. Patient history, examination, and diagnostic imaging suggested an old choroidal metastatic lesion with the patient electing chorioretinal biopsy. Upon cytologic examination, the biopsy sample indicated absence of malignant cells or tissues; however, the sample demonstrated fibroglial tissue with associated inflammation and toxoplasma organisms. Conclusion: This case demonstrates an atypical presentation of toxoplasma chorioretinitis that can mimic the appearance of a metastasis. Immunocompromised patients may be particularly susceptible to this atypical presentation of chorioretinitis.

Multifocal Toxoplasma Retinochoroiditis in a Nonimmunosuppressed Elderly Patient: Case Report and Brief Review of the Literature

Purpose To raise awareness of ophthalmologists that toxoplasmosis should be considered in the differential diagnosis of multifocal or diffuse necrotizing retinitis in nonimmunosuppressed elderly patients. Methods Interventional case report with serial color fundus photographs, indocyanine green angiography, fluorescein angiography, optical coherence tomography, and chorioretinal biopsy histology. Results A 77-year-old, nonimmunosuppressed man developed extensive multifocal retinochoroiditis with scattered focal hemorrhages and significant vitreous haze. This case posed a significant diagnostic challenge mimicking viral retinitis. Vitreous polymerase chain reaction and chorioretinal biopsy confirmed the diagnosis of toxoplasma retinochoroiditis. Conclusions As demonstrated in this case, toxoplasmosis should be considered as a cause of multifocal and/or diffuse necrotizing retinitis in elderly patients even in the absence of obvious systemic immunosuppression.