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Ocular Immunology and Inflammation Sep 2023Ocular toxoplasmosis is the leading cause of posterior uveitis worldwide, affecting individuals acrossdifferent age groups. The key to reducing vision loss includes... (Review)
Review
INTRODUCTION
Ocular toxoplasmosis is the leading cause of posterior uveitis worldwide, affecting individuals acrossdifferent age groups. The key to reducing vision loss includes prompt diagnosis and treatment. However, despite the prevalence of ocular toxoplasmosis, there has been little consensus regarding its pathophysiology,clinical features, diagnosis, and especially management.
METHODS
The data sources were literature reviews, including Pub Med and Medline databases. Search terms included toxoplasmosis, retinitis, vasculitis, vitritis, uveitis alone or in combination with, serum, aqueous, vitreous eye, ocular and review.
RESULTS
In this review paper, we have sought to provide an overview of the pathophysiology, epidemiology, and clinical features of the disease, both based on current literature and our own clinical experience. We have also discussed the use of serology, ocular fluid, and ophthalmic investigations that could further facilitate the diagnosis of ocular toxoplasmosis.Different management strategies have been reported worldwide, including newer approaches such as local therapy.
CONCLUSION
A better understanding of critical aspects of ocular toxoplasmosis will hopefully lead to reduced morbidity, including blindness associated with this condition.
Topics: Humans; Toxoplasmosis, Ocular; Eye; Uveitis; Uveitis, Posterior; Retinitis
PubMed: 36095008
DOI: 10.1080/09273948.2022.2117705 -
International Ophthalmology Jan 2022This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up and therapeutic approach of ocular toxoplasmosis focusing mainly... (Review)
Review
PURPOSE
This review aims to summarize the current knowledge concerning the clinical features, diagnostic work-up and therapeutic approach of ocular toxoplasmosis focusing mainly on the postnatally acquired form of the disease.
METHODS
A meticulous literature search was performed in the PubMed database. A supplementary search was made in Google Scholar to complete the collected items.
RESULTS
Ocular toxoplasmosis is one of the most frequent infectious etiologies of posterior uveitis. It typically presents with retinochoroiditis. Setting an accurate diagnosis depends to a considerable degree on detecting characteristic clinical characteristics. In addition to the evaluation of clinical features, the diagnosis of toxoplasmosis relies at a large degree on serologic testing. The detection of the parasite DNA in the aqueous or vitreous humor can provide evidence for a definitive diagnosis. The current mainstay for the treatment, if necessary, is the use of oral antibiotic with systemic corticosteroids. Recent evidence suggests other therapeutic approaches, such as intravitreal antibiotics can be used.
CONCLUSION
Recent developments in the diagnostic and therapeutic approach have contributed to preventing or limiting vision loss of patients suffering from ocular toxoplasmosis. Further studies are required to provide a better understanding of epidemiology, pathogenesis, diagnosis, and treatment with a significant impact on the management of this challenging clinical entity.
Topics: Chorioretinitis; Eye; Humans; Toxoplasma; Toxoplasmosis, Ocular; Uveitis, Posterior
PubMed: 34370174
DOI: 10.1007/s10792-021-01994-9 -
Ocular Immunology and Inflammation Apr 2022
Topics: Diagnostic Imaging; Humans; Toxoplasma; Toxoplasmosis, Ocular
PubMed: 35901540
DOI: 10.1080/09273948.2022.2086395 -
Ocular Immunology and Inflammation Jun 2015
Topics: Aged, 80 and over; Animals; Antibodies, Protozoan; Humans; Male; Toxoplasma; Toxoplasmosis, Ocular; Vitreous Body
PubMed: 26066570
DOI: 10.3109/09273948.2015.1051360 -
Progress in Retinal and Eye Research Mar 2021Ocular toxoplasmosis is a retinitis -almost always accompanied by vitritis and choroiditis- caused by intraocular infection with Toxoplasma gondii. Depending on retinal... (Review)
Review
Ocular toxoplasmosis is a retinitis -almost always accompanied by vitritis and choroiditis- caused by intraocular infection with Toxoplasma gondii. Depending on retinal location, this condition may cause substantial vision impairment. T. gondii is an obligate intracellular protozoan parasite, with both sexual and asexual life cycles, and infection is typically contracted orally by consuming encysted bradyzoites in undercooked meat, or oocysts on unwashed garden produce or in contaminated water. Presently available anti-parasitic drugs cannot eliminate T. gondii from the body. In vitro studies using T. gondii tachyzoites, and human retinal cells and tissue have provided important insights into the pathogenesis of ocular toxoplasmosis. T. gondii may cross the vascular endothelium to access human retina by at least three routes: in leukocyte taxis; as a transmigrating tachyzoite; and after infecting endothelial cells. The parasite is capable of navigating the human neuroretina, gaining access to a range of cell populations. Retinal Müller glial cells are preferred initial host cells. T. gondii infection of the retinal pigment epithelial cells alters the secretion of growth factors and induces proliferation of adjacent uninfected epithelial cells. This increases susceptibility of the cells to parasite infection, and may be the basis of the characteristic hyperpigmented toxoplasmic retinal lesion. Infected epithelial cells also generate a vigorous immunologic response, and influence the activity of leukocytes that infiltrate the retina. A range of T. gondii genotypes are associated with human ocular toxoplasmosis, and individual immunogenetics -including polymorphisms in genes encoding innate immune receptors, human leukocyte antigens and cytokines- impacts the clinical manifestations. Research into basic pathogenic mechanisms of ocular toxoplasmosis highlights the importance of prevention and suggests new biological drug targets for established disease.
Topics: Animals; Chorioretinitis; Eye Infections, Parasitic; Humans; Toxoplasma; Toxoplasmosis, Ocular
PubMed: 32717377
DOI: 10.1016/j.preteyeres.2020.100882 -
Ocular Immunology and Inflammation Feb 2022To present a narrative review about ocular toxoplasmosis epidemiology, disease burden and prevalent African parasitic strains. (Review)
Review
PURPOSE
To present a narrative review about ocular toxoplasmosis epidemiology, disease burden and prevalent African parasitic strains.
METHODS
An initial search for MeSH terms was conducted with a posterior advanced search in two electronic databases. Full text reading was performed.
RESULTS
Animal African studies have identified type II, type III, Africa 1, and Africa 3 strains. Seroprevalence varies from 6.4% to 74.5%. Nevertheless, there is a scarcity of epidemiology and serotyping information about ocular toxoplasmosis. African studies have demonstrated that uveitis patients present high frequencies of ocular toxoplasmosis. There is a lack of studies describing specific clinical characteristics, which can be related, to environmental and socioeconomic factors, parasite serotype and genotype, and genetic susceptibility of the host.
CONCLUSION
As has more virulent strains in the Southern hemisphere, it is relevant to determine African strain types and the correlation between the infecting strains and the clinical manifestations.
Topics: Africa; Animals; Genotype; Humans; Seroepidemiologic Studies; Toxoplasma; Toxoplasmosis, Ocular
PubMed: 32976046
DOI: 10.1080/09273948.2020.1801761 -
International Ophthalmology Clinics Apr 2022
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Acta Tropica Jan 2022Toxoplasma gondii is a widespread protozoan parasite infecting approximately one third of the world population. After proliferation of tachyzoites during the acute... (Review)
Review
Toxoplasma gondii is a widespread protozoan parasite infecting approximately one third of the world population. After proliferation of tachyzoites during the acute stage, the parasite forms tissue cysts in various anatomical sites and establishes chronic infection. Nowadays the nature of the interplay between the protozoan and its human host remains elusive. This is clearly evident in ocular toxoplasmosis, in which the parasite establishes an ambivalent relationship with the eye, manipulating the immune response and inducing variable initial lesions and further relapses. This review will focus on epidemiology and environmental, parasite and host related risk factors, clinical manifestations and laboratory findings, treatment and prophylaxis approaches in ocular toxoplasmosis. An image collection of patients referred to the Unit of Ophthalmology of Pisa's Hospital will be presented, too.
Topics: Humans; Toxoplasma; Toxoplasmosis, Ocular
PubMed: 34699742
DOI: 10.1016/j.actatropica.2021.106180 -
Transactions of the Pacific Coast... 1969
Review
Topics: Abortion, Spontaneous; Adult; Animals; Diagnosis, Differential; Eye Diseases; Female; Humans; Hypersensitivity; Infant, Newborn; Inflammation; Leucovorin; Male; Prednisone; Pregnancy; Pregnancy Complications, Infectious; Pyrimethamine; Sulfadiazine; Syphilis; Toxoplasma; Toxoplasmosis; Toxoplasmosis, Congenital; Toxoplasmosis, Ocular; Tuberculosis
PubMed: 4924569
DOI: No ID Found -
The British Journal of Ophthalmology Jan 1973
Review
Topics: Abortion, Spontaneous; Adolescent; Adult; Central Nervous System; Child; Child, Preschool; Chorioretinitis; Choroiditis; Edema; Female; Fluorescein Angiography; Humans; Infant, Newborn; Lymphadenitis; Male; Middle Aged; Pregnancy; Pregnancy Complications, Infectious; Toxoplasmosis; Toxoplasmosis, Congenital; Toxoplasmosis, Ocular; United Kingdom; Uterus; Uveitis
PubMed: 4574554
DOI: 10.1136/bjo.57.1.1