MACULAR RETINOCHOROIDAL SCARS IN TWO SIBLINGS: A PRESUMED CASE OF CONGENITAL OCULAR TOXOPLASMOSIS

Abstrak

Background: Congenital infection results from vertical transmission of Toxoplasma gondii during pregnancy and may cause permanent visual impairment due to retinochoroiditis involving the macula. Although congenital ocular toxoplasmosis is well recognized, reports involving siblings remain uncommon. Case Presentation: We report two sisters presenting with longstanding visual impairment caused by presumed congenital ocular toxoplasmosis. The first patient, a 22-year-old woman, presented with bilateral blurred vision since childhood. Best-corrected visual acuity (BCVA) was 0.16 in both eyes. Fundus examination demonstrated bilateral hyperpigmented macular retinochoroidal scars consistent with inactive toxoplasmic retinochoroiditis. The second patient, a 25-year-old woman, complained of blurred vision in the left eye since childhood. BCVA was 1.0 in the right eye and 0.20 in the left eye. Funduscopic examination revealed a solitary hyperpigmented retinochoroidal scar involving the left macula. Neither patient showed signs of active intraocular inflammation. The mother had no history of ocular toxoplasmosis or visible retinal scars. Conclusion: The occurrence of characteristic macular toxoplasmic scars in siblings strongly suggests presumed congenital ocular toxoplasmosis despite the absence of maternal ocular lesions. Recognition of congenital infection is important because macular involvement results in irreversible visual loss. Prevention of maternal infection during pregnancy and appropriate prenatal management remain essential to reduce fetal morbidity.