Author Block: Fargol Mostofian, Solin Saleh, Irfan Kherani, Chloe Gottlieb
Author Disclosure Block: F. Mostofian: None. S. Saleh: None. I. Kherani: None. C. Gottlieb: None.

Abstract Body:

Purpose: Worldwide, Toxoplasmosis is the leading cause of posterior uveitis. Atypical presentations increase misdiagnosis and risk steroid monotherapy. We discuss characteristics of atypical presentations encountered at a tertiary uveitis clinic.
Study Design: Retrospective, observational case series
Methods: Data was collected retrospectively on patient visiting an adult tertiary uveitis clinic from January 2010 to December 2017.
Results: From 55 patients with ocular toxoplasmosis, 7 cases (12.7%) were considered atypical presenting with: retinal infiltrates with history of malignancies (3 cases), optic nerve involvement (2), punctate outer retinal toxoplasmosis (PORT) (1), bilateral panuveitis (1). Diagnosis was made based on positive toxoplasmosis IgG (5 cases); positive toxoplasmosis DNA from anterior tap (1) and treatment response (1). Five patients received Trimethoprim/sulfamethoxazole (Bactrim DS) for one month and oral prednisone; the inflammation resolved in 4 cases. The PORT presentation resolved without treatment and one patient was lost to follow-up.
Conclusions: This observational study characterizes seven cases of atypical presentations of ocular toxoplasmosis. The study underlines the importance of high clinical suspicion in all age groups and diagnostic ocular and laboratory testing (intraocular and blood antibodies, PCR). Early diagnosis ensures timely treatment with anti-parasitic and improves outcomes.