Longitudinal Study of New Eye Lesions in Treated Congenital Toxoplasmosis

Phan, Laura; Kasza, Kristen; Jalbrzikowski, Jessica; Noble, A. Gwendolyn; Latkany, Paul; Kuo, Annie; Mieler, William F.; Meyers, Sanford M.; Rabiah, Peter; Boyer, Kim L.; Swisher, Charles N.; Mets, Marilyn B.; Roizen, Nancy; Cezar, Simone; Remington, Jack S.; Meier, Paul; McLeod, Rima

doi:10.1016/j.ophtha.2007.06.022

Cited by 74 publications

(60 citation statements)

References 18 publications

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“…3 Although no such period effect was observed for the long-term risk of developing retinochoroiditis, a possible impact of the treatment cannot be excluded. Indeed, a comparison of the incidences of ocular manifestations in the current study with previously published data related to untreated patients 17,18 confirms the beneficial influence of CT management. It is noteworthy that in such a large cohort of patients, neither severe bilateral visual impairment nor severe neurologic damage was encountered.…”

Section: Discussionsupporting

confidence: 85%

Ophthalmic Outcomes of Congenital Toxoplasmosis Followed Until Adolescence

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: In children with congenital toxoplasmosis, ocular lesions can be detected and may relapse after birth despite pre-and postnatal treatment. Long-term ocular outcome beyond puberty and associated prognostic factors are unknown due to limited follow-up.WHAT THIS STUDY ADDS: Our study in 477 patients with treated congenital toxoplasmosis who were followed up to 22 years indicated that new ocular lesions can be detected well into adolescence (with a cumulative probability at 18 years of almost 50%), but they rarely cause severe visual impairment. abstract BACKGROUND: Congenital toxoplasmosis (CT) can elicit severe damage to several organs, especially the eye, and may be manifested at birth or later. We assessed the long-term ocular prognosis in a cohort of congenitally infected children treated according to a standardized protocol and monitored for up to 22 years. METHODS:This prospective study included confirmed cases of CT, which were identified by obligatory antenatal screening at the Lyon (France) reference center between 1987 and 2008. Data obtained through ocular examinations were recorded on a standardized form and confirmed by an independent external committee. Risk factors for retinochoroiditis were identified by using a multivariable Cox model and a flexible model that accounted for changes in the factor effects during follow-up. RESULTS:A total of 477 of 485 infected live-born children were followed for a median of 10.5 years (75th percentile: 15.0 years). During the follow-up, 142 patients (29.8%) manifested at least 1 ocular lesion. Lesions were unilateral in 98 individuals (69.0%) and caused no vision loss in 80.6%. Lesions were first manifested at a median age of 3.1 (0.0-20.7) years. In 48 (33.8%) of the children, recurrences or new ocular lesions occurred up to 12 years after the appearance of the first lesion. Early maternal infection and confirmation of CT in children, prematurity, and nonocular CT lesions at baseline were associated with a higher risk of retinochoroiditis. CONCLUSIONS:Although the consequences of CT are rarely severe in treated children, regular postnatal monitoring is nevertheless justified because of the lifelong persisting risk of new ocular manifestations.

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Section: Discussionsupporting

confidence: 85%

Ophthalmic Outcomes of Congenital Toxoplasmosis Followed Until Adolescence

et al. 2014

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“…The most frequent time of recurrences is in adolescence. Children who were diagnosed after the first year of life, who were therefore not treated in the first year of life, had recurrences at the same ages, but had a much higher rate of development of recurrent retinal lesions [883,884].…”

Section: Eye Chorioretinitismentioning

confidence: 99%

Toxoplasmosis

Remington¹,

McLeod²,

Wilson³

et al. 2011

Infectious Diseases of the Fetus and Newborn

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“…Recent observations confi rm that it seems likely that more prompt diagnosis and treatment will result in better outcomes of congenital toxoplasmosis. New central chorioretinal lesions have been uncommon in children with congenital toxoplasmosis who are treated during their fi rst year of life [ 201 ]. This contrasts markedly with previous observations for children left untreated or those treated for one month only (≥82 % retinal lesions).…”

Section: Management Of Congenital Ocular Toxoplasmosismentioning

confidence: 61%