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Fundus topographical distribution patterns of ocular toxoplasmosis
  1. Murat Hasanreisoglu1,2,3,
  2. Muhammad Sohail Halim4,
  3. Pinar Cakar Ozdal5,
  4. Maria Soledad Ormaechea6,
  5. Cem Kesim1,
  6. Huseyin Baran Ozdemir3,
  7. Gunay Uludag6,
  8. Nripun Sredar6,
  9. Mahmut Cankurtaran5,
  10. Xiaoxuan Liu7,8,9,
  11. Alastair Keith Denniston7,8,9,
  12. Marcelo N. Rudzinski10,
  13. Daniel N. Colombero11,
  14. Bernardo Ariel Schlaen12,
  15. Pearse Andrew Keane9,13,
  16. Carlos Pavesio9,14,
  17. Quan Dong Nguyen6
  1. 1 Department of Ophthalmology, Koc University School of Medicine, Istanbul, Turkey
  2. 2 Koc University Research Center for Translational Medicine, Koc University, Istanbul, Turkey
  3. 3 Department of Ophthalmology, Gazi University School of Medicine, Ankara, Turkey
  4. 4 Ocular Imaging Research and Reading Center, Sunnyvale, California, USA
  5. 5 Department of Ophthalmology, University of Health Sciences Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
  6. 6 Byers Eye Institute, Stanford University, Palo Alto, California, USA
  7. 7 Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  8. 8 Academic Unit of Ophthalmology, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
  9. 9 Medical Retina, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  10. 10 Department of Ophthalmology, Universidad Católica de las Misiones, Posadas, Argentina
  11. 11 Department of Ophthalmology, Universidad Nacional de Rosario, Rosario, Argentina
  12. 12 Department of Ophthalmology, Hospital Universitario Austral, Buenos Aires, Argentina
  13. 13 Institute of Ophthalmology, UCL, London, UK
  14. 14 Biomedical Research Centre, UCL, London, UK
  1. Correspondence to Dr Murat Hasanreisoglu, Ophthtalmology, Koc Universitesi, Istanbul, 34010, Turkey; drhasanreisoglu{at}


Background To establish topographic maps and determine fundus distribution patterns of ocular toxoplasmosis (OT) lesions.

Methods In this retrospective study, patients who presented with OT to ophthalmology clinics from four countries (Argentina, Turkey, UK, USA) were included. Size, shape and location of primary (1°)/recurrent (2°) and active/inactive lesions were converted into a two-dimensional retinal chart by a retinal drawing software. A final contour map of the merged image charts was then created using a custom Matlab programme. Descriptive analyses were performed.

Results 984 lesions in 514 eyes of 464 subjects (53% women) were included. Mean area of all 1° and 2° lesions was 5.96±12.26 and 5.21±12.77 mm2, respectively. For the subset group lesions (eyes with both 1° and 2° lesions), 1° lesions were significantly larger than 2° lesions (5.52±6.04 mm2 vs 4.09±8.90 mm2, p=0.038). Mean distances from foveola to 1° and 2° lesion centres were 6336±4267 and 5763±3491 µm, respectively. The majority of lesions were found in temporal quadrant (p<0.001). Maximum overlap of all lesions was at 278 µm inferotemporal to foveola.

Conclusion The 1° lesions were larger than 2° lesions. The 2° lesions were not significantly closer to fovea than 1° lesions. Temporal quadrant and macular region were found to be densely affected underlining the vision threatening nature of the disease.

  • Retina
  • Inflammation
  • Infection
  • Imaging
  • Choroid

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors MH, MSH, AKD, AS, CP and QDN conceived and designed the study. MH, MSH and CK analysed the data. MH, MSH, PO, MSO, HBO, GU, MC, XL, AKD, MNR, DNC, AS, PAK, CP and QDN contributed to acquisition of data. MSH, AKD, AS, PAK, CP and QDN contributed to administrative, technical or material support. MH, MSH and CK wrote the paper. MH, AKD, AS, PAK, CP and QDN critically revised the manuscript. MH and QDN had full access to all study data and takes responsibility for the integrity of the data and the accuracy of the data analysis. QDN is guarantor. Statistical analyses were performed by MSH and CK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.