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Ocular Toxoplasmosis

Ocular Toxoplasmoses


Presentation

  • One patient with chronic lymphocytic leukaemia presented with severe posterior uveitis and total retinal detachment. Finally, the third patient presented with severe retinitis adjacent to the optic nerve and vitritis causing acute vision loss.[ncbi.nlm.nih.gov]
Retinal Lesion
  • Nonglaucomatous retinal lesions may simulate glaucomatous RNFL atrophy and visual field loss, particularly when focal damage to the retinal ganglion cells occurs.[ncbi.nlm.nih.gov]
Retinal Lesion
  • Nonglaucomatous retinal lesions may simulate glaucomatous RNFL atrophy and visual field loss, particularly when focal damage to the retinal ganglion cells occurs.[ncbi.nlm.nih.gov]
Blurred Vision
  • Suddenly blurred vision, floater, and pain could be caused by Toxoplasma gondii. Flashing, may necessitate a more precise peripheral fundus examination.[ncbi.nlm.nih.gov]
  • Box. 7191, Riyadh - 11462 Saudi Arabia Source of Support: None, Conflict of Interest: None DOI: 10.4103/0974-9233.164624 Abstract A 24-year-old healthy male presented with a chief complaint of blurred vision in the right eye for 1-week.[meajo.org]
Retinal Pigmentation
  • Human retinal pigment epithelial (RPE) cells (ARPE-19) were infected in vitro with T. gondii and collected after 60, 120, 240 min, and 24 h.[ncbi.nlm.nih.gov]
  • Optical coherence tomography (OCT) revealed left optic disc swelling, cysoid macular edema, and retinal pigment epithelial atrophy. Pupillary light reflex and color vision were normal.[evrs.eu]
  • Contd In Immunosuppressed  Have both tachyzoites and tissue cysts in areas of retinal necrosis and within retinal pigment epithelial cells.  Parasites can occasionally be found in the iris, choroid, vitreous, and optic nerve 10.[slideshare.net]
  • Ocular toxoplasmosis: the role of retinal pigment epithelium migration in infection. Parasitology Research 92, 467 – 472. Wilder, H. C. ( 1952 ). Toxoplasma chorioretinitis in adults. Archives of Ophthalmology 48, 127 – 136.[cambridge.org]
Photophobia
  • A 28-year-old man presented with a 2-week history of red eye, photophobia, pain and decreased visual acuity of the right eye.[ncbi.nlm.nih.gov]
  • Case summary: A 48-year-old man presented with a 1-week history of red eye, photophobia, eyeball pain, and decreased visual acuity of the left eye. Best corrected visual acuity was 20/200 in the left eye and 20/20 in the right eye.[evrs.eu]
  • The patients present a photophobia and floaters are seen. The slit-lamp examination reveals the presence of a granulomatous inflammation, a mild to moderate anterior chamber inflammation.[medsci.org]
  • Other complaints included photophobia, ocular pain, floaters and redness were comparable to presenting complaints seen in Kaduna, Nigeria, where reduced vision was the most common presenting complaint followed by photophobia, pain, irritation, redness[jovr.org]
  • She informed us that the pain began four days earlier, and was accompanied by photophobia. Her ocular and medical histories were unremarkable.[reviewofoptometry.com]
Facial Numbness
  • Review of systems was significant for a nonspecific light headache over the week prior to presentation, as well as right-sided facial numbness, gait ataxia, and increased anxiety.[retinalphysician.com]

Workup

  • They usually resolve after 6 weeks. [21] Workup Fluorescein angiography Fluorescein angiography (FA) of active lesions shows hypofluorescence during the early phase of the study, followed by progressive hyperfluorescence secondary to leakage.[emedicine.medscape.com]
Toxoplasma Gondii
  • This work was aimed at better understanding the impact of genotypes of Toxoplasma gondii strains on toxoplasmic retinochoroiditis.[ncbi.nlm.nih.gov]

Treatment

  • Recent data supports the use of other treatment approaches, including intravitreal antibiotics. The aim of the present review is to discuss briefly the new diagnostic tools and treatment options for ocular toxoplasmosis. 2016 S. Karger AG, Basel.[ncbi.nlm.nih.gov]
  • The side effects of each of these drugs need to be considered along with the benefits of the treatment. Further randomized clinical trials are required to determine the best standardized treatment protocol.[doi.org]

Prognosis

  • To report the clinical course and prognosis of retinal breaks and detachments occurring in patients with ocular toxoplasmosis.[ncbi.nlm.nih.gov]
  • Prognosis The prognosis is poor when congenital toxoplasmosis is acquired during the first three months of pregnancy.[medical-dictionary.thefreedictionary.com]
  • Wallon M, Kodjikian L, Binquet C et al. (2004) Long-term ocular prognosis in 327 children with congenital toxoplasmosis. Pediatrics 113: 1567–1572 PubMed CrossRef Google Scholar 81.[link.springer.com]
  • Prognosis Retinochoroiditis is the most frequent manifestation of congenital toxoplasmosis.[eyewiki.aao.org]

Etiology

  • The possibility of retinal ischemia or inflammation alone as an etiology are discussed. A 19 year old woman developed optic nerve edema and a marked decrease in vision associated with a nasal toxoplasma lesion and a macular star.[ncbi.nlm.nih.gov]
  • In a study by Nguyen et al. [ 17 ], toxoplasmosis was the most common etiology of uveitis in patients referred to a tertiary center and had a prevalence of 14% among all other etiologies.[karger.com]
  • The etiology of such hypofluorescent lesions is unknown but is suspected of being a noninfectious, perilesional inflammatory reaction.[emedicine.medscape.com]

Epidemiology

  • Considering the local epidemiological data, our OT patients seemed to be infected more frequently by ordinary type II strains found in the environment.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • The aim of the present review was to report on the results of a survey of leading uveitis experts, in which the authors asked participants to address some of the most important issues related to diagnosis, pathophysiology, and treatment of ocular toxoplasmosis[ncbi.nlm.nih.gov]
  • Review of the Series “Disease of the Year 2011: Toxoplasmosis” Pathophysiology of Toxoplasmosis . Ocular Immunology and Inflammation, Vol. 19, Issue. 5, p. 297. CrossRef Google Scholar Kristan, Deborah M. 2008.[cambridge.org]

Prevention

  • We present 2 cases of recurrent OT in immunocompetent patients for whom prophylaxis prevented recurrence of disease.[ncbi.nlm.nih.gov]
  • Prevention of Recurrences Prevention of recurrences of toxoplasmic retinochoroiditis may prevent loss of vision. Patients with paramacular toxoplasmosis may be given antimicrobial prophylaxis to prevent recurrences.[aao.org]

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