Toxoplasma gondii is an extremely successful opportunistic parasite which infects approximately one third of the human population worldwide. The impact of this parasite on human health becomes particularly manifest in congenital damage with infection and subsequent inflammation of neuronal tissues including the retina. Although advances in our understanding could be achieved in ocular toxoplasmosis, large gaps still exist on factors influencing the epidemiology and pathophysiology of this potentially blinding disease. We are only at the beginning of understanding the complex biology of this parasite and its mechanisms of invasion, virulence and interaction with the host's immune response. Since it is a preventable cause of blindness, it is necessary to assess factors that have the potential to control this disease in the future. This mini review will focus on recent advances in postnatal acquired ocular infection and the factors that may influence its prevalence and functional outcome.
Purpose: To investigate the efficacy and safety of a single dexamethasone intravitreal implant (Ozurdex®, 700 µg). Methods: In this prospective noncomparative case series, 84 patients (54 females) received a dexamethasone intravitreal implant. At weeks 4, 12 and 24 after the injection, vitreous haze, macular thickness and best corrected visual acuity (BCVA) were assessed and adverse events reported. Results: Clearance of vitreous haze could be achieved after 4 weeks in 61% of all eyes (p < 0.001) and remained significant until week 24 (p < 0.001). This was paralleled by a reduction of central retinal thickness after 4 (p < 0.001), 12 (p < 0.001) and 24 weeks (p < 0.006). Significant and fast improvement of BCVA was already achieved after 4 weeks (p < 0.001) but vanished by week 24. Intraocular pressure reached ≥35 mm Hg in 3 eyes and was significantly more frequent in intermediate uveitis compared to posterior uveitis (p < 0.016). Conclusions: The dexamethasone implant is effective in controlling intraocular posterior segment inflammation and reduces central retinal thickness fast and effectively.
Purpose Atypical disease courses of ocular toxoplasmosis (OT) have been reported in elderly patients. The aim of this study was to determine whether patient age is correlated with relevant clinical parameters. Methods A retrospective clinical study and statistical analysis was conducted on patients (n=180) with active OT. Results The age of first disease manifestation showed a clear unimodal distribution with a median incidence peak at age 26 while recurrences did not follow an age specific pattern (median= 35 years). First manifestation of OT or recurrence occurring after the age of 35 are associated with larger lesion size (2‐3 PD; contingency coefficient [CC]=0.304; p=0.047; n=60) and (CC=0.32; p=0.009) respectively. Additionally, older patients displayed uveitis anterior (63.2%; p=0.055; n=56) and vitreous involvement (89.5%; p=0.054; n=78) more frequently. Complications during OT (secondary IOP, macula and peripapillary edema, ablatio) did not correlate with patient age, but were attributable to localisation of lesions (central= 29.2% vs. peripheral=9%; p=0.039). Recurrences were present in 70% of patients (47.9%:1‐3 episodes vs. 21.8%:4‐7 episodes), whereas bi‐ocular OT always predisposes for recurrences. Standard therapy consisted of clindamycin. Large OT lesions more frequently required systemic steroid treatment (72.9% in 2‐3 PD cases vs. 48.3% in 1 PD cases; CC=0.271; p=0.007; n=124). Conclusion Patient age was significantly correlated with lesion size and inflammatory involvement of the anterior part of the eye. Localisation of lesions is a predictor for complications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.