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

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Abstract

Background

Ocular toxoplasmosis is a common cause of ocular inflammation worldwide. The aim of this study is to characterize the clinical outcomes and lesion evolution of patients with ocular toxoplasmosis and to compare the primary and reactivation subgroups.

Methods

A retrospective population-based cohort study at one uveitis-specialized tertiary referral center. Patients presenting with active ocular toxoplasmosis between the years 2007–2016 were included. Primary ocular toxoplasmosis and reactivations were compared.

Results

Included were 22 patients, 64% female with a mean age of 29 ± 18 years, 59% (n = 13) were primary, 9% (n = 2) congenital and 32% (n = 7) reactivations. Visual acuity improved from 0.38 ± 0.44 to 0.20 ± 0.27 LogMAR (P = 0.026) after a mean of 37 ± 33 months. Initial lesion size was 2.38 ± 1.1 optic disc areas, reducing to 1.56 ± 1.24 following 2 months (34% reduction, P = 0.028) and to 1.17 ± 0.87 disc areas following one year (51% reduction, P = 0.012). Patients with macula-threatening lesions had worse visual acuity (0.50 ± 0.46 vs. 0.05 ± 0.07 LogMAR, P = 0.047). Primary and reactivation subgroups had similar presentations, visual outcomes and recurrence rates (all P > 0.05).

Conclusions

In this population, primary ocular toxoplasmosis was the most common presentation. Lesion size reduced during the initial months with limited change thereafter and a third of cases recurred. Macula-threatening lesions were associated with worse visual acuity, and no significant differences were seen between the primary and reactivation subgroups.

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Authors and Affiliations

  1. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Vicktoria Vishnevskia-Dai, Asaf Achiron, Ofri Vorobichik Berar, Sivan M. Elyashiv & Idan Hecht

  2. The Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel

    Vicktoria Vishnevskia-Dai, Ofri Vorobichik Berar, Anne Ampaire Musika & Sivan M. Elyashiv

  3. Department of Ophthalmology, Edith Wolfson Medical Center, Holon, Israel

    Asaf Achiron

  4. Department of Ophthalmology, Soroka University Medical Center, The Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel

    Ortal Buhbut

  5. Department of Ophthalmology, Makerere University College of Health Sciences, Kampala, Uganda

    Anne Ampaire Musika

  6. Department of Ophthalmology, Shamir Medical Center, Tel Aviv, Israel

    Idan Hecht

Authors
  1. Vicktoria Vishnevskia-Dai
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  2. Asaf Achiron
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  3. Ortal Buhbut
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  4. Ofri Vorobichik Berar
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  5. Anne Ampaire Musika
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  6. Sivan M. Elyashiv
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  7. Idan Hecht
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Corresponding author

Correspondence to Vicktoria Vishnevskia-Dai.

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None of the authors have any conflict of interest with the submission.

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The study was performed following all the guidelines for experimental investigations required by the Institutional Review Board of the Sheba Medical Center.

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Vishnevskia-Dai, V., Achiron, A., Buhbut, O. et al. Chorio-retinal toxoplasmosis: treatment outcomes, lesion evolution and long-term follow-up in a single tertiary center. Int Ophthalmol 40, 811–821 (2020). https://doi.org/10.1007/s10792-019-01242-1

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  • DOI: https://doi.org/10.1007/s10792-019-01242-1

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