Anant Bajaj Retina Institute, LVPEI, Hyderabad, Telangana, India.
Anant Bajaj Retina Institute, LVPEI, Hyderabad, Telangana, India
BMJ Case Rep. 2023 Dec 21;16(12):e256629. doi: 10.1136/bcr-2023-256629.
We describe the clinical course and serial evolution of bacillary layer detachment (BALAD) on optical coherence tomography (OCT) in toxoplasmosis retinochoroiditis and its importance as an inflammatory biomarker. Colour fundus photography and swept-source OCT of the BALAD were done at the time of presentation and subsequently at 1 week, 2 weeks, 4 weeks and at 11 weeks. Treatment involved oral trimethoprim (160 mg) + sulphamethoxazole (800 mg) two times per day, started at presentation for 2 months. Oral prednisolone was started after 1 week at a dose of 50 mg a day and tapered weekly over the next 5 weeks. The BALAD initially increased after starting treatment with trimethoprim-sulphamethoxazole and regressed within 1 week after initiation of oral prednisolone. Best corrected visual acuity improved to 20/40 from 20/160 at presentation (Snellen equivalent). This suggests that BALAD is an indicator of an acute inflammatory event and the accumulated fluid is secondary to retinal and choroidal inflammation.
我们描述了弓形体病性视网膜炎中光学相干断层扫描（OCT）上杆菌层分离（BALAD）的临床过程和系列演变，以及其作为炎症生物标志物的重要性。在就诊时以及随后的 1 周、2 周、4 周和 11 周时，对 BALAD 进行了彩色眼底摄影和扫频 OCT 检查。治疗包括口服甲氧苄啶（160 mg）+磺胺甲恶唑（800 mg），每天两次，从就诊时开始，持续 2 个月。在开始治疗后 1 周，口服泼尼松龙 50 mg/天，在接下来的 5 周内每周逐渐减少。在用甲氧苄啶-磺胺甲恶唑开始治疗后，BALAD 最初增加，并在开始口服泼尼松龙后 1 周内消退。最佳矫正视力从就诊时的 20/160 提高到 20/40（Snellen 等价物）。这表明 BALAD 是急性炎症事件的指标，累积的液体继发于视网膜和脉络膜炎症。
