Clinical Profile and Outcomes of Patients with Toxoplasmic Retinochoroiditis: A Tertiary Care Center Experience

Hanan A Alshalan,* Nora A Alyousif,* Raneem Jannadi, Hassan Al-Dhibi Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia*These authors contributed equally to this workCorrespondence: Hanan A Alshalan, Vitreoretinal Division, King Khaled Eye Specialist Hospital, Al-Oruba Street, PO Box 7191, Riyadh, 11462, Saudi Arabia, Tel +966541161441, Email [email protected]: This study aims to characterize the demographic profile, clinical features, and treatment outcomes of patients diagnosed with toxoplasmic retinochoroiditis (TRC) at a tertiary care center in Riyadh, Saudi Arabia.Methods: A retrospective chart review was conducted on patients presenting to the uveitis service at King Khaled Eye Specialist Hospital between 2018 and 2024 with clinical signs consistent with TRC. Demographic data, clinical findings, multimodal imaging results, treatment regimens, and disease complications were collected and analyzed.Results: Thirty-three eyes of 33 patients met inclusion criteria, with a mean age of 36.5 ± 11.8 years. Recurrent disease was observed in 78.8%, while 21.2% presented with primary TRC. Lesions predominantly involved the macula (41.9%), followed by major vascular arcades (25.8%) and peripapillary regions (22.6%), with fewer cases in mid-peripheral or peripheral retina (9.7%). Optic neuritis and neuroretinitis were observed in a small subset. Ipsilateral inactive scars were common (69.7%), and contralateral scars were present in 42.4%. Complications during follow-up included optic atrophy, macular scarring, retinal tears, epiretinal membrane formation, and choroidal and retinal neovascularization.Conclusion: Toxoplasmic retinochoroiditis has diverse clinical presentations with a substantial risk of vision-threatening complications. Therefore, early recognition, especially in patients without prior chorioretinal scars, is critical for timely intervention. This study fills a crucial knowledge gap in the regional epidemiology and management of TRC, highlighting the need for larger prospective studies to refine diagnostic criteria, optimize treatment strategies, and improve long-term visual outcomes.Keywords: ocular toxoplasmosis, toxoplasmic retinochoroiditis, Toxoplasma gondii, chorioretinitis