LAUSR

Ocular toxoplasmosis occurs secondary to a retinal infection by Toxoplasma gondii, an obligate intracellular protozoan parasite. Typical ocular toxoplasmosis lesions are characterised by a unilateral, focal retinal lesion, which is usually described as necrotising retinitis and account for over 90% of presentations. The term dark without pressure (DWP) was originally coined by Nagpal et al. to describe homogeneous, geographical, flat, brown areas on the fundus and correspond to a thinned, hyporeflective ellipsoid zone band on optical coherence tomography (OCT). While most commonly seen in isolation and of unknown aetiology, their perilesional association with infective aetiology has been reported in recent studies of Ebola virus disease (EVD) retinal lesions. In EVD survivors, areas of DWP were also observed adjacent to lesions typical of ocular toxoplasmosis and in one patient observed to slowly expand over a 12-month observation (Figure 1). Here, we report a case further highlighting fluctuations of DWP associated with ocular toxoplasmosis reactivation.