Ophthalmology · Uveitis (Anterior, Posterior, Panuveitis)

In toxoplasma retinochoroiditis, the 'headlight in the fog' appearance on fundoscopy refers to:

  • A Optic disc oedema surrounded by flame haemorrhages
  • B A bright yellow retinal lesion adjacent to a white chorioretinal scar, with overlying vitritis
  • C Macular star formation with papillitis
  • D White-centred haemorrhages (Roth spots) in the posterior pole
Correct answer: B. A bright yellow retinal lesion adjacent to a white chorioretinal scar, with overlying vitritis

Explanation

The 'headlight in the fog' or 'satellite lesion' appearance in toxoplasma retinochoroiditis describes a bright white-yellow active retinal focus adjacent to a pigmented chorioretinal scar from a prior episode, surrounded by dense vitritis (the 'fog'). Toxoplasma gondii (obligate intracellular parasite) reactivates from tissue cysts within the retina. The treatment regimen (Daraprim protocol: pyrimethamine + sulfadiazine + folinic acid, with systemic steroids) is indicated for lesions threatening the macula, disc, papillomacular bundle, or causing severe vitritis. Clindamycin plus TMP-SMX are alternatives.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.

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