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Mira Ruppenstein, Michael Reich, Matthias Becker, Friederike Mackensen; Frequency of relapse in ocular toxoplasmosis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):139.
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Ocular toxoplasmosis (OT) is the leading cause of infectious posterior uveitis. It can relapse and cause function loss after each episode. Contradicting results of previous studies exist regarding frequency of relapses. The aim of this study was to identify temporal dynamics of relapses.
We contacted 156 patients with OT treated in our hospital since January 2000 and requested to complete a questionnaire addressing course, activity and possible risk factors of their disease. Results were compared and completed with data from our uveitis data base and treating ophthalmologists. Moreover we invited every patient for a clinical follow up examination. Finally, data of 84 patients could be included in this study.
The mean follow-up time was 11.4 years (range 1.3 - 55.6, SD: 9.5) with a total of 953.9 observational years. 57 (67.5%) patients were female, 27 (32.5%) patients were male. The mean age of the cohort was 40.4 years (range 7.9 - 74.3). The mean reported age at the time of clinical diagnosis was 27.2 years (range 6.7 - 69.7). A total of 280 relapses were documented, with a mean 3.2 relapses per patient (range 1-27). The mean annual relapse frequency was 0.31, median relapse free survival was 2.52 years. Relapse risk was highest (26%) in the first year after an episode and decreased with increasing disease-free intervals and duration of infection (Spearman r = -0.524). Older Patients were at higher risk than younger ones (r = 0.307). There was no temporal relation between single relapses.
Relapse rate is highest in the first year after an episode. The risk of relapse is influenced by duration of infection and patients age.
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