Ocular histoplasmosis-like syndrome: a report from a nonendemic area

Amaro, Miguel Hage; Muccioli, Cristina; Abreu, Mariza Toledo de

doi:10.1590/s0004-27492007000400003

Cited by 8 publications

(3 citation statements)

References 13 publications

(11 reference statements)

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“…Other published studies often have the same limitation as these diagnosis are frequently made on exclusion or presumed basis and ocular toxoplasmosis is only confirmed by intra-ocular fluid analyses eventually. [ 13 , 20 , 21 ] On the other hand, clinical evolution and the observed fundoscopic characteristics speaks favorably towards TRC diagnosis, cases with inaccessible retinal examination were considered ineligible and those with multiple active lesions were excluded as they lacked laboratory confirmation with intra-ocular fluid examination. Subclinical episodes were described based on sequenced retinographies but also by counting lesions, which brings a remote possibility of missed lesions in prior examinations being wrongly considered.…”

Section: Discussionmentioning

confidence: 99%

Toxoplasmic Retinochoroiditis: Clinical Characteristics and Visual Outcome in a Prospective Study

Aleixo¹,

Curi²,

Benchimol³

et al. 2016

PLoS Negl Trop Dis

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PurposeTo ascertain the clinical features and visual outcome of toxoplasma retinochoroiditis in a large series of cases.Subjects and MethodsTwo hundred and thirty subjects diagnosed with active toxoplasma retinochoroiditis were prospectively followed for periods ranging from 269 to 1976 days. All patients presented with active retinochoroiditis and positive IgG T. gondii serology at the beginning of the study and received a standardized drug treatment for toxoplasmosis, both in the first episode and in the subsequent recurrences.ResultsThe group involved 118 (51.3%) men and 112 (48.7%) women, with ages ranging from 14 to 77 years, mean of 32.4 years (SD = 11.38). Primary retinochoroidal lesions were observed in 52 (22.6%) cases and active retinochoroiditis combined with old scars in 178 (77.4%) subjects at the beginning of the study. A hundred sixty-two recurrent episodes in 104 (45.2%) patients were observed during follow-up. New subclinical retinochoroidal lesions were detected in 23 of 162 (14.2%) recurrences episodes during the follow-up. Posterior segment complications were observed in 73 (31.7%) subjects. Retinochoroidal lesions adjacent to the optic nerve and in the macular area were observed in 27 of 40 (67.5%) cases of severe visual impairment (VA = 20/200 or worse).ConclusionToxoplasma retinochoroiditis in this population had a high recurrence rate after an active episode. Severe visual impairment was associated with location of the retinochoroidal scar, recurrences and posterior segment complications. It is crucial to consider the location of the lesion in studies analyzing visual prognosis as a measure for treatment effectiveness and prevention strategies.

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Section: Discussionmentioning

confidence: 99%

Toxoplasmic Retinochoroiditis: Clinical Characteristics and Visual Outcome in a Prospective Study

Aleixo¹,

Curi²,

Benchimol³

et al. 2016

PLoS Negl Trop Dis

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“…Although POHS classically presents with more punched-out choroidal scars in the mid-periphery and with concurrent peripapillary atrophy [6,7], it is sometimes difficult to differentiate PIC and POHS lesions [1,4,8]. However, diagnosis of ocular histoplasmosis should be reserved for patients with residence in an area endemic for the fungus Histoplasma capsulatum.…”

Section: Introductionmentioning

confidence: 99%

“…5 months on average (SD 5.5, range[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Although the eyes treated by ranibizumab (n = 2) had a slightly better functional outcome (DBCVA ?1.5 lines) compared to the eyes injected with bevacizumab (n = 13, DBCVA ?0.77 lines), no conclusion can be drawn about the superiority of one of the anti-VEGF agents because of the low sample sizes.Visual acuity, refraction and functional outcomeThe refractive error was recorded in 13 (81%) eyes with a mean spherical equivalent of -4.3 dioptres (D) (SD 3.1 D, range -7.0 to 0.5 D).…”

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confidence: 99%