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International Ophthalmology Clinics Apr 2022
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The Cochrane Database of Systematic... Jan 2017Ocular infection caused by Toxoplasma gondii, a parasite, may result in inflammation in the retina, choroid, and uvea, and consequently lead to complications such as... (Review)
Review
BACKGROUND
Ocular infection caused by Toxoplasma gondii, a parasite, may result in inflammation in the retina, choroid, and uvea, and consequently lead to complications such as glaucoma, cataract, and posterior synechiae.
OBJECTIVES
The objective of this systematic review was to assess the effects of adjunctive use of corticosteroids to anti-parasitic therapy versus anti-parasitic therapy alone for ocular toxoplasmosis.
SEARCH METHODS
We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register (2016; Issue 11)), MEDLINE Ovid, Epub Ahead of Print, In-Process & Other Non-Indexed Citations, MEDLINE Ovid Daily (January 1946 to December 2016), Embase (January 1980 to December 2016), Latin American and Caribbean Literature on Health Sciences (LILACS (January 1982 to December 2016)), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP; www.who.int/ictrp/search/en). We used no date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 7 December 2016.
SELECTION CRITERIA
We had planned to include randomized and quasi-randomized controlled trials. Eligible trials would have enrolled participants of any age who were immunocompetent and were diagnosed with acute ocular toxoplasmosis. Included trials would have compared anti-parasitic therapy plus corticosteroids versus anti-parasitic therapy alone, different doses or times of initiation of corticosteroids.
DATA COLLECTION AND ANALYSIS
Two authors independently screened titles and abstracts retrieved through the electronic searches. We retrieved full-text reports of studies categorized as 'unsure' or 'include' after we reviewed the abstracts. Two authors independently reviewed each full-text report for eligibility. Discrepancies were resolved through discussion.
MAIN RESULTS
We identified no completed or ongoing trial that was eligible for this Cochrane review.
AUTHORS' CONCLUSIONS
Although research has identified a wide variation in practice regarding the use of corticosteroids, our review did not identify any evidence from randomized controlled trials for or against the role of corticosteroids in the management of ocular toxoplasmosis. Several questions remain unanswered by well-conducted randomized trials in this context, including whether the use of corticosteroids as an adjunctive agent is more effective than the use of anti-parasitic therapy alone; if so, when corticosteroids should be initiated in the treatment regimen (early versus late course of treatment), and what would be the best dose and duration of steroid use.
Topics: Adrenal Cortex Hormones; Chemotherapy, Adjuvant; Humans; Toxoplasmosis, Ocular
PubMed: 28125765
DOI: 10.1002/14651858.CD007417.pub3 -
Pathology, Research and Practice Oct 2023Toxoplasmosis is one of the highly prevalent zoonotic diseases worldwide caused by the parasite Toxoplasma gondii (T. gondii). The infection with T. gondii could pass... (Review)
Review
Toxoplasmosis is one of the highly prevalent zoonotic diseases worldwide caused by the parasite Toxoplasma gondii (T. gondii). The infection with T. gondii could pass unidentified in immunocompetent individuals; however, latent cysts remain dormant in their digestive tract, but they could be shed and excreted with feces infesting the environment. However, active toxoplasmosis can create serious consequences, particularly in newborns and infected persons with compromised immunity. These complications include ocular toxoplasmosis, in which most cases cannot be treated. Additionally, it caused many stillbirths and miscarriages. Circulating miRNAs are important regulatory molecules ensuring that the normal physiological role of various organs is harmonious. Upon infection with T. gondii, the tightly regulated miRNA profile is disrupted to favor the parasite's survival and further participate in the disease pathogenesis. Interestingly, this dysregulated profile could be useful in acute and chronic disease discrimination and in providing insights into the pathomechanisms of the disease. Thus, this review sheds light on the various roles of miRNAs in signaling pathways regulation involved in the pathogenesis of T. gondii and provides insights into the application of miRNAs clinically for its diagnosis and prognosis.
PubMed: 37683390
DOI: 10.1016/j.prp.2023.154790 -
Scientific Reports Feb 2021Although ocular toxoplasmosis is a leading cause of posterior uveitis worldwide, there is scarce information about the real-life frequency of ocular lesions, visual... (Clinical Trial)
Clinical Trial
Although ocular toxoplasmosis is a leading cause of posterior uveitis worldwide, there is scarce information about the real-life frequency of ocular lesions, visual outcomes, and risk factors for poor prognosis. We conducted a community-based cross-sectional study with 721 adults living in Cássia dos Coqueiros, Southeast Brazil, consisted of visual acuity measurement, dilated ocular examination, a risk-factor questionnaire, and peripheral blood collection for anti-T. gondii serology. Presumed toxoplasmic lesions were recorded on video and analyzed by experienced and masked ophthalmologists. Ocular toxoplasmosis was determined if at least one suspected lesion was appointed by two graders in the presence of positive anti-T. gondii serology. Forty-eight eyes (n = 42 participants; 6.7% among those with positive anti-T. gondii serology) with ocular toxoplasmosis were found. Most lesions were single (n = 28; 58.3%), peripheral (n = 34; 77.1%) and unilateral (85.7% of participants); no active lesions were found. Older age was associated with lesions larger than one-disc diameter (p = 0.047), and lower social stratum (OR: 2.89; CI 1.2-6.97; p = 0.018) was associated with the presence of toxoplasmic lesions. Although there were no differences in visual acuity between participants and eyes with or without ocular lesions (p > 0.05), unilateral blindness associated with ocular toxoplasmosis was identified in a reduced number of individuals.
Topics: Adolescent; Adult; Age Factors; Aged; Brazil; Cross-Sectional Studies; Eye Diseases; Female; Humans; Male; Middle Aged; Risk Factors; Surveys and Questionnaires; Toxoplasma; Toxoplasmosis
PubMed: 33564078
DOI: 10.1038/s41598-021-83051-0 -
Ethiopian Journal of Health Sciences Mar 2021Toxoplasmosis is the commonest cause of infectious posterior uveitis in humans and can lead to blindness and low vision in both immune-competent and immunecompromised...
BACKGROUND
Toxoplasmosis is the commonest cause of infectious posterior uveitis in humans and can lead to blindness and low vision in both immune-competent and immunecompromised persons worldwide. The aim of this study was to determine the prevalence of Ocular Toxoplasmosis (OT) and potential risk factors among livestock farmers and raw meat handlers in Uyo.
METHODS
This was a descriptive cross-sectional community-based study involving clinical eye examination, laboratory detection of anti-Toxoplasma gondii IgG antibody and HIV testing. Participants' other information was obtained using interviewer-administered questionnaire.
RESULTS
There were 339 participants aged 15-78 (mean 34.8±11.6) years,283 (83.5%) were males 56(16.5%) were females; 189 (55.8%) tested seropositive for anti-Toxo. gondiiIgG antibodies. Eight (2.4%) had presumed ocular toxoplasmosis (POT); 6 of the 8 were seropositive for anti-T.gondiiIgG antibody; and 2 of the 8 POT (25%) were HIV-seropositive. Of the 189 who were anti-T.gondiiIgG antibody seropositive, 6 (3.2%) had OT. Factors associated with OT were age (31-50 years) and female gender (P = 0.049 and 0.001, respectively). HIV infection was associated with POT (P=0.033). Most of the ocular lesions (87.5%) were unilateral and located at the posterior pole (77.7%).
CONCLUSION
The prevalence of presumed ocular toxoplasmosis (POT) and ocular toxoplasmosis (OT) among livestock farmers and raw meat handlers in Uyo are 2.4% and 1.8%, respectively. Potential risk factors are being female, and persons between fourth and fifth decades of life. Awareness creation on toxoplasmosis among this occupational group is advocated.
Topics: Adult; Animals; Antibodies, Protozoan; Cross-Sectional Studies; Farmers; Female; HIV Infections; Humans; Immunoglobulin G; Livestock; Male; Meat; Middle Aged; Nigeria; Risk Factors; Seroepidemiologic Studies; Toxoplasma; Toxoplasmosis, Ocular
PubMed: 34158777
DOI: 10.4314/ejhs.v31i2.8 -
Eye (London, England) May 2024Ocular toxoplasmosis is the most common cause of infectious posterior uveitis. Available literature is still conflicting regarding the incidence of recurrence during... (Review)
Review
Ocular toxoplasmosis is the most common cause of infectious posterior uveitis. Available literature is still conflicting regarding the incidence of recurrence during pregnancy as various calculations were employed in the different published studies. Although earlier reports have suggested a difference in presentation and an increase in severity during pregnancy, newer studies appear to show otherwise. Further diagnostic testing, including serologic and intraocular fluid sampling, may be indicated to increase the diagnostic accuracy in this special population of patients. The management of ocular toxoplasmosis during pregnancy is challenging as the foetus is additionally considered in the choice of treatment. Traditionally preferred anti-toxoplasmosis regimens containing antifolate drugs, such as pyrimethamine and trimethoprim-sulfamethoxazole, cannot be used routinely in pregnant patients, especially during the first trimester. This review includes literature on alternative treatments for ocular toxoplasmosis during pregnancy, including spiramycin and intravitreal treatment options.
Topics: Humans; Toxoplasmosis, Ocular; Pregnancy; Female; Antiprotozoal Agents; Pregnancy Complications, Parasitic; Pregnancy Complications, Infectious; Spiramycin; Anti-Bacterial Agents; Intravitreal Injections
PubMed: 38191658
DOI: 10.1038/s41433-023-02916-y -
International Journal of Infectious... Apr 2022This study aims to describe the incidence of ocular involvement in patients with toxoplasmosis and describe the sociodemographic characteristics by age, sex, and region...
OBJECTIVES
This study aims to describe the incidence of ocular involvement in patients with toxoplasmosis and describe the sociodemographic characteristics by age, sex, and region in Colombia, based on the National Health Registry of data between January 1, 2015, and December 31, 2019.
METHODS
We conducted a cross-sectional study using the Integrated Social Protection Information System database from the Colombian Ministry of Health, the unique official database in the country. We used the International Classification of Diseases for all codes of toxoplasmosis with a specific filter for ocular toxoplasmosis (OT) from 2015 to 2019 to estimate the incidence and the demographic status of the disease in Colombia.
RESULTS
During the 5 years of study, the crude unadjusted incidence of OT was 42.02 (Confidence Interval 30.29-56.19) cases in 1,000 patients with toxoplasmosis per year, showing a significant increase of incidence when comparing the year 2019 to the year 2015. There was a predominance of female patients (58% of the cases). The distribution by age shows an increase in cases of the disease in subjects aged 15 to 49 years (65.2%). The geographic analysis showed a higher proportion of cases in the Andean region, followed by the Pacific and the Atlantic regions.
CONCLUSION
This is the first study that determines the epidemiological characteristics of OT based on a National Health database in Colombia, showing a public health problem and evidencing the neediness of solidifying preventive and screening strategies in the Colombian population.
Topics: Adolescent; Adult; Colombia; Cross-Sectional Studies; Data Management; Female; Humans; Incidence; Middle Aged; Toxoplasmosis, Ocular; Young Adult
PubMed: 35189337
DOI: 10.1016/j.ijid.2022.02.028 -
Ocular Immunology and Inflammation Apr 2022To describe eight patients with toxoplasma retinochoroiditis following exposure to wild game.
PURPOSE
To describe eight patients with toxoplasma retinochoroiditis following exposure to wild game.
METHODS
Retrospective, multicenter case series.
RESULTS
Eight men, aged 29 to 71 (mean, 56 years), developed toxoplasmic retinochoroiditis after hunting and/or consuming wild game in the United States, including seven deer and one bear. Five patients developed the disease after eating undercooked game meat, while three developed ocular findings after cleaning hunted animals. Seven patients were healthy prior to exposure. LogMAR visual acuity at presentation was 0.697 ± 0.745, improving to 0.256 ± 0.335 by last follow-up. Disease complications developed in five (62.5%) patients, of which recurrence of retinochoroiditis was the most common.
CONCLUSIONS
Contact with wild game is a potential source of primary ocular toxoplasmosis in immunocompetent adults. Hunters and consumers of rare game are at risk of serious ocular disease and appropriate contact precautions and cooking may reduce this complication.
Topics: Animals; Chorioretinitis; Deer; Humans; Retrospective Studies; Toxoplasma; Toxoplasmosis, Ocular; United States; Visual Acuity
PubMed: 33560166
DOI: 10.1080/09273948.2020.1854316 -
Ocular Immunology and Inflammation Apr 2024To report a rare case of a toxoplasma chorioretinitis in one eye and peripheral ocular toxocariasis granuloma in the fellow eye of the same patient.
PURPOSE
To report a rare case of a toxoplasma chorioretinitis in one eye and peripheral ocular toxocariasis granuloma in the fellow eye of the same patient.
MATERIALS AND METHODS
Retrospective case report.
RESULTS
A 44-year-old male presented with gradual loss of vision over the past weeks. The patient was diagnosed with ocular toxoplasma chorioretinitis recurrence in his right eye and an inactive peripheral granuloma of ocular toxocariasis was found in the left eye. The patient was a farmer who had been involved in animal husbandry throughout his life. The patient was treated with antibiotics for toxoplasma chorioretinitis and kept under follow-up for ocular toxocariasis.
CONCLUSION
Coinfections of zoonoses are related to socioeconomic environment and individual characteristics of the host. Ocular toxoplasmosis and ocular toxocariasis may present with different scenarios. To our knowledge, this is the first case of a coinfection of ocular toxoplasmosis and ocular toxocariasis in the same patient. A thorough ophthalmological examination and detailed anamnesis are important for diagnosis.
PubMed: 38648624
DOI: 10.1080/09273948.2024.2344038 -
Ophthalmic Research 2017Ocular toxoplasmosis, a chorioretinal infection with Toxoplasma gondii, is the most common etiology of posterior uveitis in many countries. Accurate diagnosis depends... (Review)
Review
Ocular toxoplasmosis, a chorioretinal infection with Toxoplasma gondii, is the most common etiology of posterior uveitis in many countries. Accurate diagnosis depends heavily on the characteristic clinical features of this disease, but atypical presentations, especially in immunocompromised patients, may create diagnostic challenges and lead to misdiagnosis and inappropriate treatment. Molecular biology techniques to diagnose ocular toxoplasmosis have been available for many years and are now accessible as standard laboratory tests in many countries. Aqueous humor or vitreous evaluation to detect parasite DNA by polymerase chain reaction or specific antibody may provide definitive evidence for rapid diagnosis. Oral pyrimethamine and sulfadiazine plus systemic corticosteroids are an effective therapy for ocular toxoplasmosis. Recent data supports the use of other treatment approaches, including intravitreal antibiotics. The aim of the present review is to discuss briefly the new diagnostic tools and treatment options for ocular toxoplasmosis.
Topics: Diagnostic Techniques, Ophthalmological; Humans; Toxoplasmosis, Ocular
PubMed: 27723657
DOI: 10.1159/000449169