Profil clinique et épidémiologique de la toxoplasmose oculaire à Kinshasa

Risk factors for recurrences and visual impairment in patients with ocular toxoplasmosis: A systematic review and meta-analysis

“…Of these, 39 were included in the meta-analysis, of which 14 were conducted in South America, 13 in Europe, four in Asia, three multinational, two in North America, two Central America, and only one in Africa. In total, 4,200 patients with OT were analyzed, mean age ranged from 7.3 to 65.1 year of age [Range 1 week to 87 years] ( S3 Table ) [ 7 , 9 , 12 , 25 – 30 , 32 , 33 , 35 , 37 – 43 , 48 , 51 – 53 , 55 , 56 , 62 – 64 , 67 – 70 , 72 , 73 , 78 – 80 , 83 , 85 ]. The remaining 53 articles were included in the qualitative summary, divided into clinical and environmental factors ( Table 1 ), parasite factors ( Table 2 ), and treatment-related factors ( Table 3 ).…”

“…Concerning visual impairment, studies have found that patients > 45 years of age who debut with active lesions have a ten times higher risk of developing visual impairment [ 27 , 32 , 79 ]. Moreover, the location of the lesion also plays an essential role, as the involvement of the macular area is associated with 8.95 times more occurrence of visual impairment than the peripheral retinal compromise [ 27 , 32 , 37 , 65 ]. Also, complications (e.g.…”

“…Additionally, an age ≥50 years and the presence of lesions size >1 disc diameter (DD) had an OR of 3.27 (95% CI 1.22–8.8) and 6.30 (95% CI 2.28–22.46) for blindness, respectively [ 7 , 27 , 64 ]. Other associated factors are a history of scarring, recurrences during follow-up, and a VA <20/200 at admission [ 32 , 35 , 64 ]. Interestingly, in one article the geographical region was not statistically significantly associated with reactivations, visual impairment, and blindness [ 64 ].…”

“…Given the demonstrated high level of heterogeneity, an analysis by continental subgroups was performed, where the p-value lost statistical significance ( P = 0.63). The highest prevalence was reported in South America at 56% (95% CI 41%–69% I2 = 95%; Fig 4 ), followed by Central America at 51% (95% CI 29%–72% I2 = 83%), Europe 46% (95% CI 29%–63% I2 = 95%; Fig 4 ), and North America 39% (95% CI 9%–80% I2 = 96%; Fig 4 ) [ 7 , 26 – 30 , 32 , 35 , 37 , 38 , 40 , 42 , 48 , 52 , 55 , 63 , 64 , 68 – 70 , 73 , 78 , 80 , 83 , 85 ]. Funnel plot of all studies evidences a Fail-Safe N analysis (Fail-safe N = 32976; P<0.001), Rank correlation test (Tau = -0.058; P = 0.681), Asymetry (Z = -0.353; P = 0.724) can be found in the S1 Fig .…”

“…This was found at 35% (95% CI 25% –48%, I 2 = 80%; ( P <0.01) Fig 5A ) of cases around the world. Subgroup analysis shows that the continent with the highest prevalence of visual impairment was South America with 30% of cases (95% CI 20%–43%, I 2 = 73%; ( P = 0.01)), followed by Europe 27% (95% CI 11%–52%, I 2 = 72%; ( P = 0.06)) [ 25 , 27 , 28 , 32 , 51 , 52 , 69 , 88 ]. Funnel plot of all studies showed a Fail-Safe N analysis (Fail-safe N = 857; P <0.001), Rank correlation test (Tau = 0.333; P = 0.260), Asymetry (Z = 1.201; P = 0.230) ( S1 Fig ) .…”