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Ocular Immunology and Inflammation Oct 2020: To identify prognosis factors and functional outcomes of persistent placoid maculopathy (PPM). : We collected personal PPM cases and combined them with the data from...
: To identify prognosis factors and functional outcomes of persistent placoid maculopathy (PPM). : We collected personal PPM cases and combined them with the data from the literature. : 68 eyes of 37 patients with PPM were analyzed, including six new cases. Twenty-six patients were men (70%) with a mean age of 51.8 years old. The mean initial visual acuity (VA) was 0.52 LogMar ± 0.55 for a mean final VA of 0.49 LogMar ± 0.51. Risk factors for poor VA included: initial VA less than 0.2 LogMar ( < .0001), cardiovascular risk factor ( = .008), autoimmune-related and/or systemic pro-inflammatory conditions ( = .003), choroidal neovascularization ( = .001), macular atrophy ( = .03) and absence of systemic corticosteroid treatment ( = .03). : PPM is a choroidal inflammation. Identifying prognosis factors may help to guide treatment and follow-up. We showed that anti-inflammatory drugs, and anti-VEGF injections in cases of choroidal neovascularization, may lead to better outcomes.
Topics: Adult; Aged; Angiogenesis Inhibitors; Choroidal Neovascularization; Choroiditis; Coloring Agents; Female; Fluorescein Angiography; Glucocorticoids; Humans; Immunosuppressive Agents; Indocyanine Green; Male; Middle Aged; Multimodal Imaging; Prognosis; Retrospective Studies; Tomography, Optical Coherence; Treatment Outcome; Vascular Endothelial Growth Factor A; Visual Acuity
PubMed: 31419178
DOI: 10.1080/09273948.2019.1645187 -
Current Opinion in Infectious Diseases Oct 2019To discuss available information on the effectiveness of anti-toxoplasma therapy for ocular toxoplasmosis and to provide clinicians with a practical approach to the...
PURPOSE OF REVIEW
To discuss available information on the effectiveness of anti-toxoplasma therapy for ocular toxoplasmosis and to provide clinicians with a practical approach to the disease.
RECENT FINDINGS
Only eleven randomized studies were identified. In the three studies for acute retinitis, there was a clear trend in favor of treatment. In the two studies for the prevention of recurrences, trimethoprim-sulfamethoxazole prophylaxis was superior to placebo. In the six studies comparing different regimens, there was no statistically significant difference between the regimens. In the setting of acute posterior uveitis suspected to be caused by toxoplasma, serological testing should always be obtained, and anti-toxoplasma drug treatment, and corticosteroids should be instituted for at least 6 weeks. Toxoplasmic chorioretinitis during pregnancy represents a particular challenge.
SUMMARY
Treatment with at least two drugs and corticosteroids should be offered to patients with active toxoplasmic chorioretinitis. Pregnant women with confirmed acute infection and concomitant acute retinitis should be treated for the ocular lesion(s) and to prevent vertical transmission. Pregnant women with chronic Toxoplasma infection acquired prior to gestation and concomitant retinitis by reactivation should be treated for the retinitis and monitored for vertical transmission.
Topics: Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Antiprotozoal Agents; Diagnostic Tests, Routine; Disease Management; Female; Humans; Middle Aged; Pregnancy; Pregnancy Complications, Infectious; Pregnant Women; Randomized Controlled Trials as Topic; Toxoplasmosis, Ocular; Treatment Outcome
PubMed: 31313714
DOI: 10.1097/QCO.0000000000000577