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Follow-up and treatment results in ocular toxoplasmosis

Poster Details

First Author: T.Akcetin TURKEY

Co Author(s):    N. Dincer   K. Eltutar   S. Gurkan        

Abstract Details



Purpose:

To evaluate the clinical features, follow-up and treatment results in patients diagnosed with ocular toxoplasmosis

Setting:

Istanbul Education and Research Hospital. Istanbul; Turkey

Methods:

50 patients who have received a diagnosis of active ocular toxoplasmosis (first attack and/or recurrence) in the Ophtalmology Department of Istanbul Education and Research Hospital between 2000 and 2012 were evaluated retrospectively. The mean follow-up period was 3.2 years. Visual acuity and intraocular pressure values of the patients were recorded. Anterior and posterior segment findings were evaluated with biomicroscopy. Tests for toxoplasma-specific IgG and IgM antibodies were repeated two times with one-week intervals in cases with clinical appearance compatible with ocular toxoplasmosis.

Results:

The mean age of the patients was 29.7±14.14 years and the female/male ratio was 35/15. 32 patients (64 %) had first attack, while 18 patients (36 %) had recurrence of ocular toxoplasmosis. In 14 patients (28%), the macular retina was involved and in 16 patients (32%) the peripheral retina was involved. 9 patients (18%) had atypical signs of ocular toxoplasmosis. The posterior pole out of macula was involved in 7 patients and juxtapapillary retina was involved in 4 patients. Patients with clinical appearance compatible with ocular toxoplasmosis and positive serological tests have been given triple therapy consisting of pyrimethamine or clindamycin and sulfadiazine combination for 4-6 weeks. For cases with vision-threatening macular and posterior pole involvement, systemic prednisolone treatment was started 48 hours after initiation of antimicrobial therapy. In patients with ocular toxoplasmosis, improvement of visual acuity from 1.2±064 to 0.65±078 LogMAR unit was observed after treatment compared to that before treatment (statistically significant, p ˂ 0.001). As for complications of inflammation, posterior synechia was observed in 4 patients, cataract in 3 patients, epiretinal membranes in 2 patients, superior temporal branch retinal vein occlusion in 1 patient, optic disc pallor in 2 patients and macular edema in 1 patient.

Conclusions:

Ocular toxoplasmosis is the most common form of posterior uveitis that can lead to vision loss. The establishment of diagnosis is often based on clinical view and serological tests are helpful in the diagnostic process. The disease is self-limiting in immunocompetent patients. The purpose of the treatment is to prevent complications and recurrence. FINANCIAL INTEREST: NONE

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