Toxoplasmic retinochoroiditis: resolution without treatment of the perilesional satellite dark dots seen by indocyanine green angiography

Purpose: Satellite dark dots (SDD) seen by indocyanine green angiography (ICGA) around the main retinochoroiditis focus are described in 75% of cases. Whether SDDs represent subclinical infectious foci or just a perilesional inflammatory reaction is not known. The purpose here was to report a case giving additional information on this question. Methods: We analysed the evolution of ICGA SDDs in a patient with recurrent toxoplasmic retinochoroiditis who received no antitoxoplasmic treatment because the lesion was located outside the areas where treatment is classically recommended. Results: The patient had a recurrence of retinochoroiditis on the nasal aspect of the disc about 2 disc diameters away from the disc. It was decided to observe the recurrence before introducing treatment. Diminution of SDDs occurred by 3 weeks after the initial ICGA, and complete resolution was observed on a follow-up ICG angiogram obtained 8 weeks after the initial visit. Conclusion: Resolution of ICGA SDDs in toxoplasmic retinochoroiditis seems to occur in a similar fashion whether or not the retinochoroiditis is treated by anti-toxoplasmic drugs, indicating that SDDs probably represent a non-infectious perilesional inflammatory reaction.