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At least 19 recordsLinked to original sources
PubMed2005

[Congenital ocular toxoplasmosis--ocular manifestations and prognosis after early diagnosis of infection].

BACKGROUND: Congenital toxoplasmosis (CT) is the most frequently encountered congenital infection. The aim of the present review is to report about the long-term outcome of functional and morphological manifestations after an early confirmation of the diagnosis. PATIENTS AND METHODS: We report on a cohort of patients with serologically confirmed CT, born between 1988 and 2001, who were followed up prospectively at a single centre (Institute of Parasitology, Hôpital de la Croix Rousse, University of Lyon). All patients underwent regular ophthalmological, parasitological and paediatric controls on a half-yearly or annual basis. Ocular manifestations were documented and visual acuity was assessed as far as was possible. RESULTS: 1,506 seroconversions were diagnosed during pregnancy, and 327 of the live-born offspring were seropositive for CT. At the end of the study period, ocular manifestations occurred in 79 of the children (24 %), and in 7 cases (9 %) they were discovered during the first month of life. In 72 of the patients (91 %), the ocular manifestations developed between 1 and 151 months (median follow-up time: 6.3 +/- 3.7 years; range: 0.5 - 14 years) under medical treatment for the first year of life. At the end of the study period, information regarding visual acuity was available for 66 patients. In 55 of these (83 %), visual acuity was normal in both eyes, and in 11 (17 %), it was reduced below 0.5. In 1 child, both eyes were functionally affected, one severely. CONCLUSION: CT may not become manifest ocularly until after a decade, which underlines the necessity for long-term ophthalmological monitoring of the infected individuals. In our patients, the prognostic outcome after therapy for the first year of life was better than that reported in the literature. This favourable outcome may serve as a basis for patient counselling.

Adolescent↗
PubMed1998

Feline ocular toxoplasmosis.

Ocular infection with Toxoplasma gondii is a well-recognized and important clinical entity in many animal species. In the cat, ocular toxoplasmosis is commonly associated with systemic infection, yet its role in causing anterior uveitis in an otherwise healthy cat is unclear. The purpose of this article is to review the salient epidemiological, clinical, and histopathologic features of systemic and ocular toxoplasmosis in the cat. Additionally, pathogenesis and possible immunopathogenic mechanisms of ocular toxoplasmosis, which may account for the higher prevalence of anterior uveitis in cats seropositive for T. gondii, are discussed. Finally, diagnosis, treatment and prevention of feline toxoplasmosis are reviewed.

Journal Article↗
PubMed1982

Fuchs' heterochromic cyclitis and ocular toxoplasmosis.

Ocular toxoplasmosis and Fuchs' heterochromic cyclitis are well-defined diseases that have completely different clinical courses. We studied 13 patients (seven men and six women, ranging in age from 18 to 73 years) who had Fuchs' heterochromic cyclitis and the focal necrotizing chorioretinal lesions characteristic of ocular toxoplasmosis. The reason for this association is still unknown, as is the pathogenesis of Fuchs' heterochromic cyclitis. None of the patients had ciliary injection or posterior synechiae, but 11 of the 13 (84.6%) had keratic precipitates, anterior chamber reaction, and cataracts. Six patients (38.4%) had iris transillumination, two (15.3%) had glaucoma, and four (30.7%) had lesions in the fellow eyes.

Adolescent↗
PubMed2005

Determinants of immunodiagnostic success in human ocular toxoplasmosis.

Ocular toxoplasmosis is a local manifestation of systemic infection in which Toxoplasma spreads into the eye, affecting mainly the posterior segment of the eye. Reactivation of the initial retinal condition presumably results from the rupture of quiescent parasitic cysts lying adjacent to pre-existing scars and may secondarily involve the choroid (leading to retinochoroiditis). Although the molecular mechanisms underlying host-parasite interaction are largely unknown, toxoplasmic retinochoroiditis usually remains a local event, and does not necessarily evoke a detectable systemic immune response. Local immunotolerance mechanisms may likewise confound attempts to confirm the clinical diagnosis by serology. Aqueous humour may be analysed for the presence of parasite DNA or of specific antibodies, but the DNA burden therein is low, and a more definite confirmation would require risky puncturing of the vitreous. Laboratory confirmation of the diagnosis is also frustrated by marked individual differences in the time elapsing between the onset of clinical symptoms and the activation of specific antibody production, resulting in a high proportion of false negative results. Whether a delay in the onset of local specific antibody production reflects immunotolerance in cases of congenital - but not obviously in those of acquired - infection remains an open question, but it could account for a relatively low confirmation rate in laboratory tests for local antibody production. Against this background, current diagnostic strategies need to be re-evaluated with a view to future improvements.

Animals↗
PubMed1991

Visual impairment and blindness in ocular toxoplasmosis cases.

Ocular toxoplasmosis is a common vision-threatening disease in Indonesia. Diagnosis of this disease is based on characteristic ophthalmoscopic appearances and laboratory findings. Between 1985 and 1989, the authors retrospectively evaluated 41 children under 12 years of age. Thirteen cases had retinal lesions suspected to be toxoplasmosis but the laboratory findings were negative. The remaining 28 children had a total of 41 eyes diagnosed as ocular toxoplasmosis. Of the 41 affected eyes, vision had decreased to finger counting or less in 23 (56%) eyes and to less than 6/15 in 9 (22%) eyes. In five (12.2%) eyes vision was greater than 6/15, and in four (9.8%) eyes the status of vision was unknown. In addition to the usual signs of toxoplasmosis, signs of strabismus and nystagmus were evident in the cases reviewed. Thus, ocular toxoplasmosis should be suspected in patients, particularly children, with those clinical signs.

Blindness↗
PubMed1983

Congenital ocular toxoplasmosis.

Congenital ocular toxoplasmosis is a significant cause of blindness. Retinochoroiditis is the most common finding, but other ocular manifestations include microphthalmus, nystagmus, strabismus, and ptosis. The serologic tests and lymphocyte stimulation test are the most useful aids in making the diagnosis. Pyrimethamine, sulfonamides, and corticosteroids are useful to treat active lesions. Primary care physicians, obstetricians, and ophthalmologists may help to prevent transmission of the disease and its serious ocular sequelae.

Chorioretinitis↗
PubMed1999

Fas-FasL interaction involved in pathogenesis of ocular toxoplasmosis in mice.

Ocular toxoplasmosis is a potentially blinding intraocular inflammation. The intent of this study was to investigate the role of Fas-FasL interaction in a murine model of acquired ocular toxoplasmosis induced by intracameral inoculation of Toxoplasma gondii. Intraocular inflammation, Fas and FasL expression on lymphocytes and on ocular tissues, the occurrence of apoptosis, and the frequency of CD8(+) and CD4(+) T cells in the infected eyes were analyzed in C57BL/6 (B6) mice. Susceptibility to parasite-induced intraocular inflammation was observed in Fas-deficient (B6-lpr) and FasL-deficient (B6-gld) mice. Inoculation of 5,000 T. gondii tachyzoites induced significant intraocular inflammation associated with increase of Fas and FasL expression in the inoculated eyes of wild-type B6 mice. Flow cytometry demonstrated a significant increase of Fas and FasL expression on the splenocytes from naive mice incubated in vitro with the parasite and on the splenocytes harvested from the infected mice at day 8 after parasite inoculation. Apoptosis of inflammatory cells and cells in ocular tissues was seen, and a greater frequency of CD8(+) than CD4(+) T cells was observed in the infected eyes. The intensity of intraocular inflammation was greater in B6-lpr and B6-gld mice than in wild-type B6 mice (P < 0.05). The results suggest that Fas-FasL interaction associated with apoptosis is involved in the pathogenesis of acquired ocular toxoplasmosis in mice.

Animals↗
PubMed2005

[Ocular toxoplasmosis: our experience].

Ocular toxoplasmosis can be a progressive and recurring disease that can threaten visual function. Retinochoroiditis develops gradually weeks to years after subclinical congenital toxoplasmosis; this is the preponderant form, which is frequently bilateral; with healing, white or dark-pigmented scars may result. Toxoplasmosis acquired in older children and adults rarely progresses to retinochoroiditis; it is generally unilateral. We report the results of a clinical study concerning 16 patients with ocular toxoplasmosis observed for the first time in the period from 1992 to 2004 and followed up until today. The patients came to the Department of Infectious Diseases of the Second University of Naples. We studied 16 patients, 10 of whom were females; 11 cases presented ocular signs of congenital toxoplasmosis, while in 5 cases ocular impairment was related to an acquired toxoplasmosis. Only one case of congenital toxoplasma chorioretinitis was symptomatic at birth: it was complicated by microphthalmia and strabismus, calcifications in the brain and epilepsy; 10 congenital cases were asymptomatic at birth and were recognized after several years because of a reactivation of infection. In 5 patients congenital chorioretinitis was bilateral, with presence of scars in the contralateral eye. The 5 cases of acquired toxoplasma retinitis were ascertained by anamnestic, serologic and ophthalmologic examinations; in 4 of them the lesion was typical and unilateral; the 5th case was a 6-year-old boy with acquired toxoplasma bilateral neuroretinitis. 13/16 cases of ocular toxoplasmosis were treated with the combination of pyrimethamine, sulfadiazine; they were followed up and re-treated if necessary. The therapy was curative in each case. Our experience confirms that late-onset retinal lesions and relapse can occur many years after birth but that the overall ocular prognosis is satisfactory when congenital damage is recognized early and treated appropriately. Prevention of congenital and acquired toxoplasmosis is very important in controlling ocular toxoplasmosis.

Adolescent↗
PubMed1990

Ocular toxoplasmosis--clinical aspect.

Ocular toxoplasmosis in non immuno-deficients can take 3 major aspects: 1) Pseudo-acquired (congenital) forms in teenagers and young adults; 2) Congenital forms in the newborn; 3) Acquired toxoplasmosis.

Humans↗
PubMed2002

Atypical presentations of ocular toxoplasmosis.

The diagnosis of ocular toxoplasmosis is based most often on the presence of characteristic clinical findings, which include focal retinochoroiditis, an adjacent or nearby retinochoroidal scar, and moderate to severe vitreous inflammation. However, a variety of less common, "atypical" presentations may be unfamiliar to clinicians, delaying both diagnosis and treatment. Patients who are immunocompromised or elderly may, for example, present with large, multiple and/or bilateral lesions. Other unusual manifestations include punctate outer retinal toxoplasmosis, retinal vasculitis, retinal vascular occlusions, rhegmatogenous and serous retinal detachments, a unilateral pigmentary retinopathy mimicking retinitis pigmentosa, neuroretinitis and other forms of optic neuropathy, and scleritis. Although in the past most cases of ocular toxoplasmosis were considered to result from reactivation of a congenital infection, it is now believed that postnatally acquired infection accounts for many cases of this disease. With appropriate use of antiparasitic therapy, the visual prognosis for patients with both typical and atypical forms of ocular toxoplasmosis may be good.

Choroiditis↗
PubMed1979

[Ocular toxoplasmosis (author's transl)].

Ocular toxoplasmosis is a disease characterised by inflammation of posterior part of uvea. It can be either congenital or acquired. However, ocular toxoplasmosis is mostly congenital. The frequency of ocular involvement is 1/4 in ratio after invasion of central nervous system. Ocular and serological findings must be considered together for diagnosis. Pyrimethamine and sulphonamides are effective in the treatment of acute cases; however, they have no effect on chronic cases. It is not advised to use corticosteroids alone, but they may be used together with their depo-forms and other antimicrobial drugs. In addition, physical methods such as, laser photocoagulation or cryotherapy can be employed when drug treatment is not effective.

Humans↗
PubMed1996

Restricted applicability of the polymerase chain reaction for the diagnosis of ocular toxoplasmosis.

The laboratory confirmation of ocular toxoplasmosis has been reported to be facilitated by the polymerase chain reaction (PCR) technique in anterior chamber taps. We utilized PCR specific for a sequence of the Toxoplasma gondii B 1 gene with a length of 194 bp. The sensitivity was adjusted to ten genomic copies per sample in stained gel and two copies after DNA hybridization using a digoxygenin-labeled probe. We amplified DNA from 43 aqueous, 14 serum, and 32 white blood cell (WBC) samples obtained from 31 consecutive otherwise healthy patients with the clinical diagnosis of ocular toxoplasmosis. In the series investigated, 1/43 aqueous samples and 2/32 WBC samples were found to contain detectable amounts of target DNA. An inhibition of the PCR by the aqueous humor as a reason for the low detection rates was excluded. Thus, we conclude that either the sensitivity of aqueous humor PCR is not sufficient for use in the routine diagnosis of ocular toxoplasmosis in immuno-competent individuals or the anterior chamber is not the proper compartment for investigation of this protozoal disease using this approach.

Adult↗
PubMed1992

[Results of the treatment of ocular toxoplasmosis in personal experience].

Ocular toxoplasmosis manifested itself in following clinical forms: as central serous chorioretinitis, pars planitis, iritis, intrabulbar neuritis and central retinal degeneration. The diagnosis was based on the clinical picture, serological examinations, the course of the disease and the effect of the specific treatment. The authors used piridimide++ compounds, sulfonamides, steroids, folic acid and Tavegyl, Decaris as well as photo-coagulation. The efficacy of all these methods was compared.

Adult↗