Prevalence, Clinical Characteristics, and Causes of Vision Loss in Patients with Ocular Toxoplasmosis

Abstract

Ocular toxoplasmosis is a common cause of uveitis. Our patients were more likely than general uveitis patients to be young, male, and Latino, often having emigrated from Mexico or Central or South America. The most common contributors to decreased vision in eyes with active lesions were inflammation and macular involvement, whereas in eyes with inactive lesions they were macular scar formation and amblyopia.

Clinical pattern of ocular toxoplasmosis treated in a referral centre in Serbia

“…24 Patients with OT are generally young adults, and in our study group, 76% of the patients were younger than 45 years. Similar results were found in other studies, 5,18,22,23,25 for instance, Bosch-Driessen et al 5 showed that the mean age at first presentation of OT was 29.5 years and that patients with primary ocular lesions were significantly older than those with combinations of active lesions and old scars. Also, Garweg et al 25 reported that the mean age at the first occurrence of OT was 23.9 years and patients with only one episode were older at first manifestation than those with two episodes (29.6 and 17.9 years, respectively).…”

“…Primary OT at first presentation has been reported at rates of 28-42.5%. 5,6,22,23 The greater frequency of recurrent disease may be accounted for by old peripheral lesions that go unnoticed by the patient; this is also supported by our clinical findings of a combination of active lesions and old retinochoroidal scars at a greater frequency than the patients were aware of.…”

“…The 1.7% of cataract was similar to the findings of Balasundaram et al 30 and Tugal-Tutkun et al, 26 but considerably lower than the 13% reported by Bosch-Driessen et al; 5 the comparatively high rate of complications in the latter series is presumably due to the longer follow-up. Interestingly, although raised IOP is often associated with an OT episode 23,29,30 glaucoma as a complication is rare; that is, in the study of TugalTutkun et al, although an IOP rise was seen in 8% patients during active OT, there was no case of glaucoma as a complication, 26 nor was it seen in the series of Balasundaram et al 30 In our series, one case was complicated by glaucoma secondary to OT.…”

“…This resulted in an end-of-treatment unilateral legal blindness in 24% patients, all of which had central lesions. Predominance of OT lesions within the vascular arcades has been commonly observed, 5,18,22,23 for instance, of up to 84.2% of unilateral and 75% of bilateral cases in Italy, 18 in a tertiary setting like ours where patients without visual impairment are infrequent, and of 73% in a Colombian cohort study. 22 In contrast, in a population-based study in Brazil, peripheral lesions predominated (58.5%).…”

“…5 At a rate of 73%, monocular presentation was clearly predominant and was within the range (64.3-86.4%) reported in other studies. 18,22,23 …”