Ocular toxoplasmosis II: clinical features, pathology and management
Top Cited Papers
Open Access
- 19 June 2012
- journal article
- review article
- Published by Wiley in Clinical & Experimental Ophthalmology
- Vol. 41 (1), 95-108
- https://doi.org/10.1111/j.1442-9071.2012.02838.x
Abstract
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.Keywords
This publication has 116 references indexed in Scilit:
- Longitudinal Study of New Eye Lesions in Children with Toxoplasmosis Who Were Not Treated During the First Year of LifeAmerican Journal of Ophthalmology, 2008
- Comparison of Immunoblotting, Calculation of the Goldmann-Witmer Coefficient, and Real-Time PCR Using Aqueous Humor Samples for Diagnosis of Ocular ToxoplasmosisJournal of Clinical Microbiology, 2008
- Intravitreal triamcinolone acetonide as an adjunct in the treatment of severe ocular toxoplasmosisEye, 2008
- Necrotising retinopathies simulating acute retinal necrosis syndromeBritish Journal of Ophthalmology, 2005
- Toxoplamosis transmitted to a newborn from the mother infected 20 years earlierAmerican Journal of Ophthalmology, 2003
- Comparison of Enzyme-Linked Immunosorbent Assay, Immunoblotting, and PCR for Diagnosis of Toxoplasmic ChorioretinitisJournal of Clinical Microbiology, 2003
- Use of the polymerase chain reaction for diagnosis of ocular toxoplasmosisOphthalmology, 1999
- Ocular opportunistic infection incidences among patients who are HIV positive compared to patients who are HIV negativeOphthalmology, 1998
- RECURRENT OCULAR TOXOPLASMOSIS IN PATIENTS TREATED WITH SYSTEMIC CORTICOSTEROIDSRetina, 1996
- Optic neuritis due to acquired toxoplasmosisPediatric Neurology, 1985