Chorio-retinal toxoplasmosis: treatment outcomes, lesion evolution and long-term follow-up in a single tertiary center

Vishnevskia‐Dai, Vicktoria; Achiron, Asaf; Buhbut, Ortal; Berar, Ofri Vorobichik; Musika, Anne A; Elyashiv, Sivan; Hecht, Idan

doi:10.1007/s10792-019-01242-1

Cited by 9 publications

(10 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In congenital toxoplasmosis, chorioretinitis may be present even at birth, with chorioretinal scars or focal necrotizing retinitis. It may also appear unpredictably during childhood or adolescence, as a new manifestation or as a reactivation of a previous lesion ( 37 ). The symptoms are scotoma, pain, photophobia, blurred vision, and excessive watering of the eye ( 22 ).…”

Section: Ocular Toxoplasmosismentioning

confidence: 99%

“…Among ocular manifestations, the most frequent is chorioretinitis and the retinal lesions are usually in the posterior pole ( 22 , 35 ). Most frequently occurs after a reactivation of the infection and in cases where the macula is involved there may be a loss of visual function ( 22 , 36 , 37 ). Worsening of central vision, because of macula involvement, may recover after resolution of the inflammation ( 22 ).…”

Section: Neonatal Clinical Manifestationsmentioning

confidence: 99%

See 1 more Smart Citation

Congenital Toxoplasmosis: The State of the Art

et al. 2022

View full text Add to dashboard Cite

Infection with the protozoan parasite Toxoplasma gondii occurs worldwide and usually causes no symptoms. However, a primary infection of pregnant women, may infect the fetus by transplacental transmission. The risk of mother-to-child transmission depends on week of pregnancy at the time of maternal infection: it is low in the first trimester, may reach 90% in the last days of pregnancy. Inversely, however, fetal disease is more severe when infection occurs early in pregnancy than later. Systematic serologic testing in pregnant women who have no antibodies at the beginning of pregnancy, can accurately reveal active maternal infection. Therefore, the risk of fetal infection should be assessed and preventive treatment with spiramycin must be introduced as soon as possible to reduce the risk of mother-to-child transmission, and the severity of fetal infection. When maternal infection is confirmed, prenatal diagnosis with Polymerase Chain Reaction (PCR) on amniotic fluid is recommended. If fetal infection is certain, the maternal treatment is changed to a combination of pyrimethamine-sulfonamide and folinic acid. Congenitally infected newborns are usually asymptomatic at birth, but at risk for tardive sequelae, such as blindness. When congenital infection is evident, disease include retinochoroiditis, cerebral calcifications, hydrocephalus, neurocognitive impairment. The diagnosis of congenital infection must be confirmed at birth and management, specific therapy, and follow-up with multidisciplinary counseling, must be guaranteed.

show abstract

Section: Ocular Toxoplasmosismentioning

confidence: 99%

Section: Neonatal Clinical Manifestationsmentioning

confidence: 99%

Congenital Toxoplasmosis: The State of the Art

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Over 70% of patients presenting with acute ocular toxoplasmosis already have ocular scars, suggesting that disease progression is driven by the inflammatory response to recrudescent T. gondii leading to the accumulation of tissue damage over time (149). Immune-competent individuals are able to control ocular infection, but early antiparasitic treatment is critical to limit the extent of retinal damage (150). Human retinal vascular endothelial cells are more sensitive to infection than other endothelial cell types, suggesting a potential mechanism of entry into the eye (151).…”

Section: Ocular Toxoplasmosismentioning

confidence: 99%

The molecular biology and immune control of chronic Toxoplasma gondii infection

Zhao¹,

Ewald²

2020

Journal of Clinical Investigation

View full text Add to dashboard Cite

“…Furthermore, in the meta-analysis by Pradhan et al, the outcome of lesion size was considered, but the analyzed studies did not report it [13]. The methods described in the literature for measuring lesion size include the following: fundoscopic images, in which the lesion and optic disc areas were measured using Photoshop software and the ratio of the lesion to optic disc area was calculated [48]; a program written in the MATLAB environment made to determine the margin of the retinitis and to measure the area of interest in pixels [44]; and the retinal lesion size in terms of ≤ 1 disc area (DA), < 1 and ≤ 2 DA, and < 2 and ≤ 3 DA. "Improvement" was considered a lesion size that decreased in terms of DA classification [37].…”

Section: Agreements and Disagreements With Other Studies Or Reviewsmentioning

confidence: 99%

Safety and efficacy of different antibiotic regimens in patients with ocular toxoplasmosis: systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

Background Ocular toxoplasmosis (OT) is the most common cause of posterior uveitis, which leads to visual impairment in a large proportion of patients. Antibiotics and corticosteroids lower the risk of permanent visual loss by controlling infection and inflammation. However, there remains disagreement regarding optimal antibiotic therapy for OT. Therefore, this systematic review and meta-analysis were performed to determine the effects and safety of existing antibiotic treatment regimens for OT. Methods MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials, LILACS, WHO International Clinical Trials Registry Platform portal, ClinicalTrials.gov, and Gray Literature in Europe (“OpenGrey”) were searched for relevant studies; manual searches of reference lists were performed for studies identified by other methods. All published and unpublished randomized controlled trials that compared antibiotic schemes known to be effective in OT at any dosage, duration, and administration route were included. Studies comparing antibiotics with placebo were excluded. This review followed standard methodological procedures recommended by the Cochrane group. Results Ten studies were included in the narrative summary, of which four were included for quantitative synthesis (meta-analysis). Interventions were organized into three groups: intravitreal clindamycin versus pyrimethamine + sulfadiazine, trimethoprim + sulfamethoxazole versus other antibiotics, and other interventions. The first comparison favored intravitreal clindamycin (Mean difference (MD) = 0.10 logMAR; 95% confidence interval = 0.01 to 0.22). However, this finding lacks clinical relevance. Other outcomes showed no statistically significant differences between the treatment groups. In general, the risk of performance bias was high in evaluated studies, and the quality of the evidence found was low to very low. Conclusions No antibiotic scheme was superior to others, and the selection of a treatment regimen depends on multiple factors; therefore, treatment should be chosen based on safety, sulfa allergies, and availability.

show abstract

Chorio-retinal toxoplasmosis: treatment outcomes, lesion evolution and long-term follow-up in a single tertiary center

Cited by 9 publications

References 19 publications

Congenital Toxoplasmosis: The State of the Art

Congenital Toxoplasmosis: The State of the Art

The molecular biology and immune control of chronic Toxoplasma gondii infection

Safety and efficacy of different antibiotic regimens in patients with ocular toxoplasmosis: systematic review and meta-analysis

Contact Info

Product

Resources

About