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Klinische Monatsblatter Fur... Apr 2016Although the seroprevalence of toxoplasmosis has undergone a progressive 50 % decline during the past 20 years, the disease remains an economically important health... (Review)
Review
INTRODUCTION
Although the seroprevalence of toxoplasmosis has undergone a progressive 50 % decline during the past 20 years, the disease remains an economically important health hazard in many countries. Ocular toxoplasmosis (OT) is the most frequent cause of infectious posterior uveitis, and new insights into its pathophysiology have paved the way for new therapeutic strategies.
METHODS
This review summarises recent insights into the disease, its clinical manifestations and therapeutic options. The data have been gleaned from a PubMed search, which was conducted in August 2015 using the key term "ocular toxoplasmosis".
RESULTS
A laboratory confirmation of the diagnosis serves as the basis for estimating the clinical burden of OT. This is more severe in South America than in Europe, due to the higher incidence of the more virulent New World parasitic strains. It is not yet possible to differentiate between acquired and congenital cases in most patients. However, in elderly individuals, clinical manifestations of acquired OT are more frequently encountered and in atypical forms. Although inflammation may initially be more pronounced in acquired than in congenital cases of OT, the final visual acuity is usually better and the risk of recurrence lower. Amongst the numerous therapeutic options, none is clearly superior. In immunocompromised individuals and in those with frequent recurrences, prophylactic measures should be considered.
CONCLUSION
OT is still a potentially vision-threatening affection, namely in elderly individuals with acquired disease and in those patients harbouring the more aggressive New World strains of the parasite. Owing to the limitations in diagnostic sensitivity and therapeutic efficacy, treatment strategies have to be tailored to the individual needs.
Topics: Antiprotozoal Agents; Blindness; Humans; Prevalence; Risk Factors; Toxoplasmosis, Ocular
PubMed: 27116531
DOI: 10.1055/s-0041-111821 -
International Ophthalmology Oct 1990Toxoplasmosis is a common infection of man and animals. The disease is widespread in nature and has a worldwide distribution. The infection is caused by the organism... (Review)
Review
Toxoplasmosis is a common infection of man and animals. The disease is widespread in nature and has a worldwide distribution. The infection is caused by the organism Toxoplasma gondii which was first isolated by Nicolle and Manceaux in Tunis from a North African rodent. The disease can be congenital or acquired with a variety of clinical manifestations that may range from a subclinical course to a generalized infection with fatal outcome. The ocular manifestations of the disease include sudden onset of floaters with blurring of vision. Toxoplasmosis causes a localized necrotizing retinitis with inflammation of the subjacent choroid. The retina sustains the primary injury and the major damage.
Topics: Animals; Humans; Retinal Diseases; Toxoplasma; Toxoplasmosis, Ocular
PubMed: 2249911
DOI: 10.1007/BF00163555 -
Clinical Laboratory Jul 2023Toxoplasmosis is a zoonotic illness caused by Toxoplasma gondii. Ocular infection frequently manifests as acute necrotizing retinal chorioretinitis. In this paper, we... (Review)
Review
BACKGROUND
Toxoplasmosis is a zoonotic illness caused by Toxoplasma gondii. Ocular infection frequently manifests as acute necrotizing retinal chorioretinitis. In this paper, we describe a case of retinal chorioretinitis caused by Toxoplasma gondii infection, as well as the most recent diagnostic and treatment techniques.
METHODS
Serum and vitreous fluid were collected and analyzed, and PCR for Toxoplasma gondii DNA, ELISA for Toxoplasma gondii IgG and Goldmann-Witmer coefficient, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), and fundus autofluorescence were done (FAF).
RESULTS
Toxoplasma gondii DNA (-), serum and vitreous IgG from Toxoplasma gondii (+) cells, and the Goldmann-Witmer coefficient of Toxoplasma gondii were all considerably enhanced, indicating Toxoplasma gondii infection. Antiparasitic infection in combination with an anti-inflammatory glucocorticoid were given, laser treatment of the fundus was provided, and the patient's condition has been stable with no indication of recurrence to date following conclusion of therapy.
CONCLUSIONS
Toxoplasma gondii can infect the whole retina, causing variable degrees of visual impairment; thus, rapid diagnosis and tailored therapy are necessary to enhance prognosis and reduce disease recurrence.
Topics: Humans; Toxoplasmosis, Ocular; Chorioretinitis; Toxoplasma; Polymerase Chain Reaction; Antibodies, Protozoan; Immunoglobulin G
PubMed: 37436370
DOI: 10.7754/Clin.Lab.2022.221122 -
Ophthalmology Clinics of North America Sep 2002Toxoplasmosis is the most common infectious cause of posterior uveitis. Although the classic presentation including moderate to severe vitreous inflammation associated... (Review)
Review
Toxoplasmosis is the most common infectious cause of posterior uveitis. Although the classic presentation including moderate to severe vitreous inflammation associated with a focal retinochoroiditis and an adjacent or nearby retinochoroidal scar offers little diagnostic difficulty, numerous atypical presentations have been recognized. Here, both serologic and PCR-based analyses can be used to support the diagnosis in clinically challenging cases. Treatment decisions can be complex and need to be individualized for each patient.
Topics: Humans; Toxoplasmosis, Ocular
PubMed: 12434481
DOI: 10.1016/s0896-1549(02)00030-5 -
International Ophthalmology Clinics 1990
Review
Topics: Animals; Humans; Toxoplasma; Toxoplasmosis, Ocular
PubMed: 2228473
DOI: 10.1097/00004397-199030040-00009 -
International Ophthalmology Clinics 1981
Review
Topics: Adrenal Cortex Hormones; Animals; Anti-Bacterial Agents; Cat Diseases; Cats; Female; Humans; Pregnancy; Pregnancy Complications, Infectious; Toxoplasmosis, Animal; Toxoplasmosis, Ocular
PubMed: 7026485
DOI: 10.1097/00004397-198102130-00015 -
Ocular Immunology and Inflammation Apr 2023
Topics: Humans; Toxoplasmosis, Ocular; Uveitis; Toxoplasma; Antibodies, Protozoan
PubMed: 35499545
DOI: 10.1080/09273948.2022.2037658 -
International Ophthalmology Oct 1990Ocular toxoplasmosis in non immuno-deficients can take 3 major aspects: 1) Pseudo-acquired (congenital) forms in teenagers and young adults; 2) Congenital forms in the... (Review)
Review
Ocular toxoplasmosis in non immuno-deficients can take 3 major aspects: 1) Pseudo-acquired (congenital) forms in teenagers and young adults; 2) Congenital forms in the newborn; 3) Acquired toxoplasmosis.
Topics: Humans; Toxoplasmosis, Ocular
PubMed: 2249912
DOI: 10.1007/BF00163556 -
Current Opinion in Ophthalmology Dec 2003The concepts of toxoplasmosis and its ocular manifestations in humans have thoroughly changed in the past 3 years. This review addresses new epidemiologic data,... (Review)
Review
PURPOSE OF REVIEW
The concepts of toxoplasmosis and its ocular manifestations in humans have thoroughly changed in the past 3 years. This review addresses new epidemiologic data, specifically the occurrence of ocular disease in postnatal infections, and puts the changed views on the frequency and pathogenesis of toxoplasmic ocular manifestations into historical perspective.
RECENT FINDINGS
Newly described clinical presentations are discussed together with their recent diagnostic possibilities. The new data on congenital or postnatal acquisition of infection and their importance for ocular involvement are presented as well as the high prevalence of 79% of recurrent disease in ocular toxoplasmosis, which cannot be prevented by short-term treatments. Recently published analyses of literature showed, unexpectedly, the lack of efficacy of short-term treatments for ocular disease as well as of the long-term prenatal treatments on fetal transmission rate and the severity of congenital disease.
SUMMARY
The recent guidelines for treatment are included together with the up-to-date recommendations for the treatment of ocular toxoplasmosis in the immunosuppressed host.
Topics: Africa, Western; Europe; Humans; Immunocompromised Host; Incidence; Infant; Prevalence; Risk Factors; Toxoplasmosis, Ocular
PubMed: 14615644
DOI: 10.1097/00055735-200312000-00011 -
Clinical & Experimental Ophthalmology 2013Ocular toxoplasmosis results from retinal infection with the protozoan, Toxoplasma gondii. This parasite, which exists as multiple clonal subpopulations and in three... (Review)
Review
Ocular toxoplasmosis results from retinal infection with the protozoan, Toxoplasma gondii. This parasite, which exists as multiple clonal subpopulations and in three stages, is capable of replication in any nucleated cell of its primary feline or multiple paratenic hosts. Human seroprevalence of toxoplasmosis is high across the globe, but with geographic variation. While prevalence of ocular toxoplasmosis is not well documented, toxoplasmic retinochoroiditis is the commonest form of posterior uveitis in many countries. Correlation of parasite genotype with disease is an important area of new research. Ocular infection with T. gondii often follows ingestion of bradyzoites in undercooked infected meat. Oocysts may survive for an extended period in the environment, and water contaminated with oocysts is an important source in toxoplasmosis epidemics. Ocular toxoplasmosis is preventable by a combination of community activities and personal measures. Public health action is well justified by the considerable burden of congenital and postnatal infections.
Topics: Animals; Chorioretinitis; Global Health; Humans; Public Health; Toxoplasma; Toxoplasmosis, Ocular
PubMed: 22594908
DOI: 10.1111/j.1442-9071.2012.02821.x