Ocular Toxoplasmosis: Lessons From Brazil

Grigg, Michael E.; Dubey, J. P.; Nussenblatt, Robert B.

doi:10.1016/j.ajo.2015.04.005

Cited by 41 publications

(44 citation statements)

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“…The prevalence of ocular toxoplasmosis in Brazil is high, and the severity and risk of ocular involvement are notably higher compared to the United States and Europe (Glasner et al, 1992;Garcia et al, 1999;Aleixo et al, 2009;Furtado et al, 2013;Grigg et al, 2015). Studies in the northwestern region of São Paulo showed that seroprevalence was 74.5%, of these, 27.3% had ocular disease (Ferreira et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…The high rates of ocular disease caused by T. gondii infection in Brazil is still unknown, and it is still not clear why these strains can cause more ocular involvement than in the rest of the world. Genetic diversity of these strains and host immune response are important factors that have been related to the severity of this disease in Brazil (Grigg et al, 2001(Grigg et al, , 2015Silveira et al, 2015;Greigert et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Serological and Molecular Tests Used for the Identification of Toxoplasma gondii Infection in Patients Treated in an Ophthalmology Clinic of a Public Health Service in São Paulo State, Brazil

Murata

Previato

Frederico

et al. 2020

Front. Cell. Infect. Microbiol.

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Ocular toxoplasmosis is one of the most common complications caused by the infection with the parasite Toxoplasma gondii. The risk of developing eye lesions and impaired vision is considered higher in Brazil than other countries. The clinical diagnosis is difficult and the use of sensitive and specific laboratorial methods can aid to the correct diagnosis of this infection. We compared serological methods ELISA and ELFA, and molecular cPCR, Nested PCR and qPCR for the diagnosis of T. gondii infection in groups of patients clinically evaluated with ocular diseases non-toxoplasma related (G1 = 185) and with lesions caused by toxoplasmosis (G2 = 164) in an Ophthalmology clinic in Brazil. Results were compared by the Kappa index, and sensitivity (S), specificity (E), positive predictive value (PPV), and negative (NPV) were calculated. Serologic methods were in agreement with ELISA more sensitive and ELFA more specific to characterize the acute and chronic infections while molecular methods were discrepant where qPCR presented higher sensitivity, however, lower specificity when compared to cPCR and Nested PCR.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Serological and Molecular Tests Used for the Identification of Toxoplasma gondii Infection in Patients Treated in an Ophthalmology Clinic of a Public Health Service in São Paulo State, Brazil

Murata

Previato

Frederico

et al. 2020

Front. Cell. Infect. Microbiol.

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“…Nonetheless, there is still no consensus about the best protocol for monitoring clinical cases of toxoplasmosis in humans, especially in countries where there is a great variability of T. gondii strains, presence of atypical strains, and severe clinical involvement. TMP/SMX was indicated for treatment of OT, but this drug combination can control parasitemia only for a short period of time [9,[38][39][40][41][42][43][44][45].…”

Section: Discussionmentioning

confidence: 99%

Toxoplasmose ocular com reação em cadeia da polimerase positiva em sangue periférico – relato de dois casos, estado de São Paulo, Brasil

Barbosa¹,

Frederico²,

Previato³

et al. 2016

Sci Med

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Aims:To describe the use of polymerase chain reaction (PCR) in peripheral blood and demonstrate its importance in the clinical follow-up of patients with ocular toxoplasmosis. Case description: Two immunocompetent patients were clinically diagnosed with acute ocular toxoplasmosis. The routine clinical evaluation consisted of fundus examination using binocular indirect ophthalmoscopy, color fundus photography, fluorescein angiography, and spectral domain optical coherence tomography. The serological diagnosis was made by enzyme-linked immunosorbent assay (ELISA) and confirmed by enzyme-linked fluorescent assay (ELFA). The molecular diagnosis was made by PCR in peripheral blood using the B1 gene of Toxoplasma gondii as marker. The younger patient was male, had previous lesion in the right eye, complained of low visual acuity in the left eye and was under treatment. The older patient was male, had retinal detachment, and presented with sudden loss of acuity in the right eye. The fundus examination revealed chorioretinal scar in the left eye. IgG was reactive, IgM was non-reactive, and PCR was positive in the peripheral blood of both patients. New blood samples were collected for serological and molecular monitoring and PCR remained positive in both cases. Six weeks after treatment with oral sulfadiazine and pyrimethamine, the PCR yielded negative results. Conclusions:The results show that T. gondii antigens may be found in peripheral blood during ocular reactivations and that PCR may be a good tool for the follow-up of patients with ocular toxoplasmosis.KEY WORDS: Toxoplasma gondii; toxoplasmosis, ocular; retinochoroiditis; chorioretinitis; retinography; optical coherence tomography; PCR; polymerase chain reaction RESUMO Objetivos: Descrever o uso da reação em cadeia da polimerase (PCR) no sangue periférico e demonstrar sua importância no acompanhamento clínico de pacientes com toxoplasmose ocular. Descrição dos casos: Dois pacientes imunocompetentes foram clinicamente diagnosticados com toxoplasmose ocular aguda. Rotineiramente, a avaliação clínica foi feita por fundoscopia com o uso de oftalmoscópio binocular indireto, retinografia colorida, angiografia fluorescente e tomografia de coerência óptica espectral. A sorologia foi realizada por ensaio imunoenzimático (ELISA) e confirmada por ensaio imunoenzimático fluorescente ELFA (IgG, IgM). O diagnóstico molecular foi realizado por PCR em sangue periférico usando o gene B1 de Toxoplasma gondii como marcador. O paciente mais jovem era do sexo masculino, apresentava lesão prévia no olho direito, queixa de baixa acuidade visual no olho esquerdo e estava sob tratamento. O paciente mais velho era do sexo masculino, apresentava descolamento de retina e súbita diminuição de visão no olho direito. A fundoscopia revelou cicatriz coriorretiniana no olho esquerdo. Ambos os pacientes tinham IgG reagente, IgM não reagente e PCR positivo em sangue periférico. Novas amostras de sangue foram coletadas para monitoramento sorológico e molecular e a PCR permaneceu positiva e...

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“…68 However, the majority of cases of ocular toxoplasmosis, at least in the United States and Europe, are likely to be acquired postnatally and to become symptomatic "in the second and third decade of life." 69,70 Other Infections Toxoplasma gondii has been discussed in detail to illustrate how an infectious agent could explain many of the ocular symptoms in schizophrenia, but other infectious agents could also do so. Congenital rubella, ie, has been associated with an increased incidence of autism, mood disorders, and schizophrenia-spectrum disorders.…”

Section: Complement Activation and Neuronal Connectivitymentioning

confidence: 99%

Schizophrenia and Infections: The Eyes Have It

Torrey

Yolken

2016

SCHBUL

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The visual tract is prominently involved in schizophrenia, as evidenced by perceptual distortions and a type of nystagmus found in many individuals affected. Genetic explanations for these abnormalities have been suggested. This study proposes an alternate explanation based on infection. Several infectious agents thought to be associated with some cases of schizophrenia are known to cause both infection of the fetus and abnormalities of the eye. Toxoplasma gondii is examined in detail, and rubella, cytomegalovirus, varicellazoster virus, and herpes simplex virus more briefly. Careful ophthalmic assessments, including funduscopy and direct examination of tissues for infectious agents, will clarify the role of such agents in ocular aspects of schizophrenia.

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Ocular Toxoplasmosis: Lessons From Brazil

Cited by 41 publications

References 30 publications

Evaluation of Serological and Molecular Tests Used for the Identification of Toxoplasma gondii Infection in Patients Treated in an Ophthalmology Clinic of a Public Health Service in São Paulo State, Brazil

Evaluation of Serological and Molecular Tests Used for the Identification of Toxoplasma gondii Infection in Patients Treated in an Ophthalmology Clinic of a Public Health Service in São Paulo State, Brazil

Toxoplasmose ocular com reação em cadeia da polimerase positiva em sangue periférico – relato de dois casos, estado de São Paulo, Brasil

Schizophrenia and Infections: The Eyes Have It

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