Pars plana vitrectomy for vitreoretinal complications of ocular toxoplasmosis

Adán, Alfredo; Giralt, J.; Álvarez, G.; Alforja, Socorro; Burés-Jesltrup, Anniken; Casaroli-Marano, Ricardo P.; Corcóstegui, Borja

doi:10.1177/112067210901900622

Cited by 33 publications

(19 citation statements)

References 18 publications

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“…Pars plana vitrectomy was performed in 16.8% of the eyes in the current study. Vitreous surgery can be performed safely in ocular toxoplasmosis and may result in improved visual acuity in selected cases [19]. …”

Section: Discussionmentioning

confidence: 99%

Clinical Pattern of Toxoplasmic Retinochoroiditis in a Spanish Referral Center

et al. 2013

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Background/Aims: To analyze the clinical pattern of ocular toxoplasmosis in a referral center in Spain. Methods: The medical records of consecutive patients with ocular toxoplasmosis admitted from a single referral center for uveitis in Barcelona (Spain) were retrospectively analyzed between January 2005 and January 2011. Results: One hundred and thirteen eyes from 113 patients (74 Spanish and 39 South American) with active ocular toxoplasmosis were analyzed with a 12-month follow-up. Final BCVA ≤20/200 was found in 30 eyes (26.5%). The most frequent complications were macular edema (16.8%) and epiretinal membrane (11.5%). Anterior chamber cell scores of ≥2+ (p = 0.003), vitreous cell scores of ≥2+ (p = 0.001), and the presence of cataracts (p = 0.047) or serous retinal detachment (p = 0.008) were more common among the South American than Spanish cohort. Active macular lesions (p < 0.001) with an initial BCVA ≤20/200 (p < 0.001) and advanced age (p = 0.019) were predictors for final BCVA ≤20/200, whereas female gender (p = 0.021) and an initial BCVA ≤20/200 (p = 0.045) were predictors for ocular complications. Moreover, a BCVA ≤20/200 (p < 0.001) and a vitreous cell score of ≥2+ (p = 0.045) at the initial examination were predictors of an eventual need for ocular surgery. Conclusion: The clinical features of ocular toxoplasmosis in Spanish patients differ from those of South American patients. In general, active macular lesions with an initial BCVA ≤20/200 and advanced age were shown to be predictors for final BCVA ≤20/200 in our patient cohort.

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Section: Discussionmentioning

confidence: 99%

Clinical Pattern of Toxoplasmic Retinochoroiditis in a Spanish Referral Center

et al. 2013

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“…However, in some cases, OT can lead to loss of vision, optic nerve or macular affection, and vitreous opacities [18]. Previous studies [19] have shown that pars plana vitrectomy can be performed safely on patients with OT who suffer from vitreoretinal complications. Our findings in this case report are consistent with these results.…”

Section: Discussionmentioning

confidence: 99%

Anaphylactic reaction to intravenous corticosteroids in the treatment of ocular toxoplasmosis: a case report

et al. 2014

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IntroductionThis case report presents for the first time an acute systemic allergic reaction to corticosteroids in a patient with ocular toxoplasmosis after treatment with intravenous cortisone, and discusses alternative treatments.Case presentationWe present the case of a 57-year-old Caucasian woman with an anaphylactic reaction after intravenous injection of prednisolone-21-hydrogensuccinate (Solu-Decortin® H) given for the treatment of toxoplasmosis-associated chorioretinitis. Immediately after the injection, she developed an acute erythema of the legs and abdomen, angioedema, hypotension (blood pressure 80/40mmHg), tachycardia (heart rate 140/minute), hyperthermia (38.8°C), and respiratory distress. Allergological examinations showed a positive skin-prick test to prednisolone and methylprednisolone. In addition, an oral exposure test with dexamethasone (Fortecortin®) and betamethasone (Celestamine®) was conducted to find alternative corticosteroids for future treatments. After oral application, no local or systemic reactions were observed for these two substances.ConclusionsThis case report demonstrates that systemic allergic reactions are possible in patients with uveitis or other inflammatory ophthalmological conditions treated with intravenous corticosteroids. Intravenous administration of cortisone, for example, in the treatment of ocular toxoplasmosis, should always be conducted with caution because of a possible allergic reaction. For patients who react to a particular steroid, it is necessary to undergo allergological testing to confirm that the compound in question is indeed allergenic, and to identify other corticosteroids that are safe for future anti-inflammatory treatments.

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“…[1] Inflammatory ERM secondary to toxoplasmic retinochoroiditis, although uncommon, often does not resolve and needs surgical removal. [45] Adan and associates reported visual improvement after vitrectomy and membrane peeling in two patients with ERM associated with ocular toxoplasmosis. [4] When we noted the thick ERM developing in our patient, we also explained the option of future surgery to her.…”

Section: Discussionmentioning

confidence: 99%

“…[45] Adan and associates reported visual improvement after vitrectomy and membrane peeling in two patients with ERM associated with ocular toxoplasmosis. [4] When we noted the thick ERM developing in our patient, we also explained the option of future surgery to her. However, on regular follow-up visits, as the retinochoroiditis lesions showed regression, ERM gradually contracted and separated spontaneously along with PVD.…”

Section: Discussionmentioning

confidence: 99%