Active ocular toxoplasmosis in Turkish patients: a report on 109 cases

Abstract

Most of the patients with active ocular toxoplasmosis have asymptomatic retinochoroidal scars. Proximity of active lesions to the scars, and especially to those of the most recent episode, may have implications for treatment. Although the recurrence risk is high, the visual prognosis is good in most patients with typical ocular toxoplasmosis.

The Impact of Short-Term, Intensive Antifolate Treatment (with Pyrimethamine and Sulfadoxine) and Antibiotics Followed by Long-Term, Secondary Antifolate Prophylaxis on the Rate of Toxoplasmic Retinochoroiditis Recurrence

“…We did not find any differences in the frequency of recurrences between genders, but female patients predominated in our series. The same was observed by Garweg et al and Reich et al, but not by Tungal-Tutkun et al [ 29 , 30 , 36 ]. One possible explanation is that women pay more attention to their health and tend to attend scheduled follow-up visits more regularly.…”

“…In our material two patients only had the clinical and serological features of a recent invasion. The number was similar to the study of Tungal-Tutkum et al but much smaller than in most other studies, most likely due to the exclusion from the present analysis of patients who did not form atrophic scars after TRC [ 36 , 37 ]. Such type of inflammation in the course of TRC was described by other authors at the stage of acute primary invasion [ 40 ].…”

“…The analysis of recurrence free-survival after first admission showed the probability of a 3-year recurrence-free interval in 90.9% of patients, a significantly higher percentage than reported by Tungal-Tutkun et al [ 36 ] and Reich et al [ 30 ] or Garweg et al (if the interval between the primary lesion and the first reactivation is considered) [ 29 , 22 ]. None of the authors, however, used A-SP and some patients did not receive any antiparasitic drugs [ 37 ].…”

The Impact of Short-Term, Intensive Antifolate Treatment (with Pyrimethamine and Sulfadoxine) and Antibiotics Followed by Long-Term, Secondary Antifolate Prophylaxis on the Rate of Toxoplasmic Retinochoroiditis Recurrence

“…We did not find any differences in the frequency of recurrences between genders, but female patients predominated in our series. The same was observed by Garweg et al and Reich et al, but not by Tungal-Tutkun et al [ 29 , 30 , 36 ]. One possible explanation is that women pay more attention to their health and tend to attend scheduled follow-up visits more regularly.…”

“…In our material two patients only had the clinical and serological features of a recent invasion. The number was similar to the study of Tungal-Tutkum et al but much smaller than in most other studies, most likely due to the exclusion from the present analysis of patients who did not form atrophic scars after TRC [ 36 , 37 ]. Such type of inflammation in the course of TRC was described by other authors at the stage of acute primary invasion [ 40 ].…”

“…The analysis of recurrence free-survival after first admission showed the probability of a 3-year recurrence-free interval in 90.9% of patients, a significantly higher percentage than reported by Tungal-Tutkun et al [ 36 ] and Reich et al [ 30 ] or Garweg et al (if the interval between the primary lesion and the first reactivation is considered) [ 29 , 22 ]. None of the authors, however, used A-SP and some patients did not receive any antiparasitic drugs [ 37 ].…”

Clinical pattern of ocular toxoplasmosis treated in a referral centre in Serbia

“…The 1.7% of cataract was similar to the findings of Balasundaram et al 30 and Tugal-Tutkun et al, 26 but considerably lower than the 13% reported by Bosch-Driessen et al; 5 the comparatively high rate of complications in the latter series is presumably due to the longer follow-up. Interestingly, although raised IOP is often associated with an OT episode 23,29,30 glaucoma as a complication is rare; that is, in the study of TugalTutkun et al, although an IOP rise was seen in 8% patients during active OT, there was no case of glaucoma as a complication, 26 nor was it seen in the series of Balasundaram et al 30 In our series, one case was complicated by glaucoma secondary to OT.…”

“…22,26 However, the rate of vitritis was lower than generally reported, 22,26,29,30 which may suggest that the level of vitreous haze was not always reliably recorded, particularly if low.…”

The Impact of Short-Term, Intensive Antifolate Treatment (with Pyrimethamine and Sulfadoxine) and Antibiotics Followed by Long-Term, Secondary Antifolate Prophylaxis on the Rate of Toxoplasmic Retinochoroiditis Recurrence

“…We did not find any differences in the frequency of recurrences between genders, but female patients predominated in our series. The same was observed by Garweg et al and Reich et al, but not by Tungal-Tutkun et al [ 29 , 30 , 36 ]. One possible explanation is that women pay more attention to their health and tend to attend scheduled follow-up visits more regularly.…”

“…In our material two patients only had the clinical and serological features of a recent invasion. The number was similar to the study of Tungal-Tutkum et al but much smaller than in most other studies, most likely due to the exclusion from the present analysis of patients who did not form atrophic scars after TRC [ 36 , 37 ]. Such type of inflammation in the course of TRC was described by other authors at the stage of acute primary invasion [ 40 ].…”

“…The analysis of recurrence free-survival after first admission showed the probability of a 3-year recurrence-free interval in 90.9% of patients, a significantly higher percentage than reported by Tungal-Tutkun et al [ 36 ] and Reich et al [ 30 ] or Garweg et al (if the interval between the primary lesion and the first reactivation is considered) [ 29 , 22 ]. None of the authors, however, used A-SP and some patients did not receive any antiparasitic drugs [ 37 ].…”

Clinical pattern of ocular toxoplasmosis treated in a referral centre in Serbia

“…The 1.7% of cataract was similar to the findings of Balasundaram et al 30 and Tugal-Tutkun et al, 26 but considerably lower than the 13% reported by Bosch-Driessen et al; 5 the comparatively high rate of complications in the latter series is presumably due to the longer follow-up. Interestingly, although raised IOP is often associated with an OT episode 23,29,30 glaucoma as a complication is rare; that is, in the study of TugalTutkun et al, although an IOP rise was seen in 8% patients during active OT, there was no case of glaucoma as a complication, 26 nor was it seen in the series of Balasundaram et al 30 In our series, one case was complicated by glaucoma secondary to OT.…”

“…22,26 However, the rate of vitritis was lower than generally reported, 22,26,29,30 which may suggest that the level of vitreous haze was not always reliably recorded, particularly if low.…”

The Impact of Short-Term, Intensive Antifolate Treatment (with Pyrimethamine and Sulfadoxine) and Antibiotics Followed by Long-Term, Secondary Antifolate Prophylaxis on the Rate of Toxoplasmic Retinochoroiditis Recurrence

“…We did not find any differences in the frequency of recurrences between genders, but female patients predominated in our series. The same was observed by Garweg et al and Reich et al, but not by Tungal-Tutkun et al [ 29 , 30 , 36 ]. One possible explanation is that women pay more attention to their health and tend to attend scheduled follow-up visits more regularly.…”

“…In our material two patients only had the clinical and serological features of a recent invasion. The number was similar to the study of Tungal-Tutkum et al but much smaller than in most other studies, most likely due to the exclusion from the present analysis of patients who did not form atrophic scars after TRC [ 36 , 37 ]. Such type of inflammation in the course of TRC was described by other authors at the stage of acute primary invasion [ 40 ].…”

“…The analysis of recurrence free-survival after first admission showed the probability of a 3-year recurrence-free interval in 90.9% of patients, a significantly higher percentage than reported by Tungal-Tutkun et al [ 36 ] and Reich et al [ 30 ] or Garweg et al (if the interval between the primary lesion and the first reactivation is considered) [ 29 , 22 ]. None of the authors, however, used A-SP and some patients did not receive any antiparasitic drugs [ 37 ].…”

Clinical pattern of ocular toxoplasmosis treated in a referral centre in Serbia

“…The 1.7% of cataract was similar to the findings of Balasundaram et al 30 and Tugal-Tutkun et al, 26 but considerably lower than the 13% reported by Bosch-Driessen et al; 5 the comparatively high rate of complications in the latter series is presumably due to the longer follow-up. Interestingly, although raised IOP is often associated with an OT episode 23,29,30 glaucoma as a complication is rare; that is, in the study of TugalTutkun et al, although an IOP rise was seen in 8% patients during active OT, there was no case of glaucoma as a complication, 26 nor was it seen in the series of Balasundaram et al 30 In our series, one case was complicated by glaucoma secondary to OT.…”

“…22,26 However, the rate of vitritis was lower than generally reported, 22,26,29,30 which may suggest that the level of vitreous haze was not always reliably recorded, particularly if low.…”