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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 -
Turkiye Parazitolojii Dergisi Jun 2020Toxoplasmosis is a common infection worldwide caused by , an intracellular parasite. The prevalence of Toxoplasmosis ranges from 17.5% to 69.5% in Turkey. Toxoplasmosis... (Review)
Review
Toxoplasmosis is a common infection worldwide caused by , an intracellular parasite. The prevalence of Toxoplasmosis ranges from 17.5% to 69.5% in Turkey. Toxoplasmosis is mostly asymptomatic. It may cause fetal mortality in case of vertical passage. The most common clinical findings in congenital toxoplasmosis are chorioretinitis, hydrocephalus and cerebral calcification. Another group of susceptible patients for are immunesuppressive patients. Reactivation of a latent infection in the case of immunodeficiency can lead to fatal toxoplasmic encephalitis. Serological diagnostic methods based on the detection of specific antibodies for are the most commonly used diagnostic methods. However, it may be difficult to interpret the results in pregnant women, neonates, and the patients receiving treatment. It is stated that using more than one method together to improve the reliability of the diagnosis is a more accurate approach. In the prenatal diagnosis of congenital toxoplasmosis, in patients with immunodeficiency, in ocular toxoplasmosis, the polymerase chain reaction is seen as having a higher sensitivity. The aim of this review is to present the general features, diagnostic methods and current approaches in toxoplasma infection, an important public health problem.
Topics: Adult; Antibodies, Protozoan; Female; Humans; Immunocompromised Host; Infant, Newborn; Infectious Disease Transmission, Vertical; Polymerase Chain Reaction; Pregnancy; Pregnancy Complications, Parasitic; Prenatal Diagnosis; Prevalence; Reproducibility of Results; Toxoplasma; Toxoplasmosis; Toxoplasmosis, Congenital; Turkey
PubMed: 32482042
DOI: 10.4274/tpd.galenos.2020.6634 -
Case Reports in Ophthalmology 2022Neuroretinitis is an inflammatory condition with rapid unilateral vision loss, optic disc edema, and macular star formation. While neuroretinitis is commonly due to...
Neuroretinitis is an inflammatory condition with rapid unilateral vision loss, optic disc edema, and macular star formation. While neuroretinitis is commonly due to infectious causes such as , neuroretinitis due to toxoplasmosis is uncommon. A 29-year-old male presents to our neuro-ophthalmology clinic on December 7, 2021, at the University of Arkansas for Medical Sciences with symptoms of left eye pain and blurred vision. Subsequent workup led to the diagnosis and treatment of toxoplasma neuroretinitis. The fundus exam eventually demonstrated a notable macular star. Treatment was well tolerated, and the patient regained total visual acuity in the affected eye. Toxoplasma neuroretinitis is known for a characteristic appearance of optic disc edema prior to appearance of stellate maculopathy with vitreous inflammation and peripheral chorioretinal scars. Although loss of vision due to toxoplasmosis is rare, it should be included as part of the differential diagnosis with pertinent history.
PubMed: 36845446
DOI: 10.1159/000526682 -
Frontiers in Cellular and Infection... 2021
Topics: Antibodies, Protozoan; Biology; Humans; Toxoplasma; Toxoplasmosis, Ocular
PubMed: 33768015
DOI: 10.3389/fcimb.2021.652637 -
Saudi Journal of Ophthalmology :... 2018A number of ocular diseases can be attributed to contaminated water and we have coined a term "Water-related ocular diseases (WRODs)" to denote this wide-spectrum of... (Review)
Review
A number of ocular diseases can be attributed to contaminated water and we have coined a term "Water-related ocular diseases (WRODs)" to denote this wide-spectrum of conditions. WRODs are directly related to human contact with water and can occur through toxic, allergic, inflammatory or infective mechanisms. The non-infective causes can include chemicals used to clean swimming pools, oil spills and water-sport related injuries. Similarly, a number of infective organisms causing ocular diseases are transmitted through water. Since, these conditions can occasionally prove devastating, a review was done with the following aims: (i) To study the epidemiology of WRODs (ii) To assess the clinical presentation and current management of WRODs (iii) To highlight the future challenges and possible solutions to these problems. The online search was conducted utilizing search engines such as PubMed, Google Scholar, ClinicalKey and the Virtual Library of the Ministry of Health, Malaysia for relevant terms such as water-borne, swimming pool and eye infections.
PubMed: 30224888
DOI: 10.1016/j.sjopt.2017.10.009 -
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 -
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 -
Clinical & Experimental Ophthalmology 2013The term, ocular toxoplasmosis, refers to eye disease related to infection with the parasite, Toxoplasma gondii. Recurrent posterior uveitis is the typical form of this... (Review)
Review
The term, ocular toxoplasmosis, refers to eye disease related to infection with the parasite, Toxoplasma gondii. Recurrent posterior uveitis is the typical form of this disease, characterized by unilateral, necrotizing retinitis with secondary choroiditis, occurring adjacent to a pigmented retinochoroidal scar and associated with retinal vasculitis and vitritis. Multiple atypical presentations are also described, and severe inflammation is observed in immunocompromised patients. Histopathological correlations demonstrate focal coagulative retinal necrosis, and early in the course of the disease, this inflammation is based in the inner retina. For typical ocular toxoplasmosis, a diagnosis is easily made on clinical examination. In atypical cases, ocular fluid testing to detect parasite DNA by polymerase chain reaction or to determine intraocular production of specific antibody may be extremely helpful for establishing aetiology. Given the high seroprevalence of toxoplasmosis in most communities, serological testing for T. gondii antibodies is generally not useful. Despite a lack of published evidence for effectiveness of current therapies, most ophthalmologists elect to treat patients with ocular toxoplasmosis that reduces or threatens to impact vision. Classic therapy consists of oral pyrimethamine and sulfadiazine, plus systemic corticosteroid. Substantial toxicity of this drug combination has spurred interest in alternative antimicrobials, as well as local forms of drug delivery. At this time, however, no therapeutic approach is curative of ocular toxoplasmosis.
Topics: Animals; Antiprotozoal Agents; Chorioretinitis; Drug Therapy, Combination; Glucocorticoids; Humans; Pyrimethamine; Sulfadiazine; Toxoplasma; Toxoplasmosis, Ocular
PubMed: 22712598
DOI: 10.1111/j.1442-9071.2012.02838.x -
Arquivos Brasileiros de Oftalmologia 2022Toxoplasma gondii infection can cause ocular manifestations after acquired and congenital disease. We report two cases of symptomatic congenital toxoplasmosis with...
Toxoplasma gondii infection can cause ocular manifestations after acquired and congenital disease. We report two cases of symptomatic congenital toxoplasmosis with ocular involvement in non-twin siblings, with a 2-year interval between pregnancies. Vertical transmission of toxoplasmosis in successive pregnancies, which was once considered impossible, is now found to be plausible even in immunocompetent subjects.
Topics: Pregnancy; Female; Humans; Toxoplasmosis, Congenital; Toxoplasmosis, Ocular; Siblings; Infectious Disease Transmission, Vertical; Eye; Toxoplasma
PubMed: 35170636
DOI: 10.5935/0004-2749.20220079 -
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