Causes of visual impairment in patients with ocular toxoplasmosis

Abstract

Introduction: The aim of this study was to report the causes of visual impairment in patients with the classic clinical presentation of ocular toxoplasmosis (OT). Methodology: Eight patients with OT underwent standardized ophthalmologic examination and fundus imaging. Macula and the lesions that could be visualized were evaluated by spectral domain optical coherence tomography (SOCT) at presentation. The scan acquisition protocols for SOCT included a radial line scan through the retinochoroiditis lesion, radial line macular scan, and horizontal volume scans at the macula. Results: The mean age of the five (62.5%) women and three (37.5%) men was 25.7±7.6 years. The mean logMAR ETDRS best-corrected visual acuity was 0.45 (Snellen equivalent, 20/50). SOCT findings of macula were normal in seven patients, and one patient had decreased retinal thickness from a healed chorioretinitis at the fovea. Of eight patients, two had 3+ vitreous haze, four had 2+ vitreous haze, and two had 1+ vitreous haze at presentation. OCT scans revealed vitreous hyperreflective dots in all patients with different densities in different radial scans. Hyperreflective dots were denser in macular scans of eyes in which the active lesion was closer to the fovea. Conclusions: In this study, visual impairment in majority of the patients was found to be related to vitreous cells and flare. Dense vitritis on macula scans and visual impairment were seen in the patients who had an active lesion closer to the fovea. SOCT may provide objective data of the cellular load of the eyes with posterior segment inflammation.

Neurological manifestations due to congenital toxoplasmosis, verified through the literature integrative review

“…In the second report on ocular manifestations due to congenital toxoplasmosis, which has published in 2017, the occurrence of toxoplasmosis associated with visual impairment was reported in eight patients, attended between 2012 and 2013, for the first ophthalmic evaluation at a hospital in Turkey [9].…”

Congentinal Central Toxoplasma Chorioretinitis - Case Study

“…Objevuje se u 70-90 % pacientů s vrozenou formou onemocnění, méně často pak jako komplikace získané primární nákazy [13]. Z dalších očních příznaků kongenitální toxoplasmosy jsou popisovány mikroftalmie, kongenitální katarakta, glaukom anebo strabismus [5,10,12,13,14,19].…”

“…Její výskyt se odhaduje okolo 25-30 % celosvětově, ale může se výrazně lišit mezi jednotlivými kontinenty či státy [15,17]. Popsány jsou rovněž rozdíly mezi různými komunitami v rámci jednoho regionu [1,15,19] kovou léčbu, což by mohlo výrazně zkrátit dobu podání celkové terapie a tím zlepšit compliance pacientů.…”

“…K dalším očním komplikacím, které byly v literatuře popsány, patří vitritida, epiretinální membrána, subretinální kolekce tekutiny až vývoj serózního odchlípení sítnice [19,26].…”