Recent advances in the management of ocular toxoplasmosis.

Clinically in both the congenital and the acquired ocular disease, there is an acute focal chorioretinitis having its active onset of recurrence between ages 11 and 40 years old. Lesions may be single, variable in size, and are usually posterior to the equator. There is exudation into the vitreous and flare and cells in the anterior chamber. Vitreous may detach from the retina, with hemispheric collections of cells looking like keratic precipitates deposited on the back of the vitreous body and dubbed vitreous precipitates. The active disease often occurs next to an old scar to produce the so-called satellite lesion, it is usually one disc diameter in size, although it may vary from pinpoint to extremely large. Activity in the lesion persists for about 4 months. It is less frequent in blacks and most frequent in teenage girls. Papillitis and papilledema are not uncommon. A rare type of vitreous reaction with the development of grapevines in the vitreous covered with wet snow may be seen. If the macular area is not involved, and the inflammation is mild, the condition maybe asymptomatic. Activity of a lesion is manifested by its softness and elevation and by the presence of cells in the vitreous over it, although the latter may persist in the vitreous for months. Their presence, therefore, is not an absolute guide.