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Marcelo Valeiras, Diego Bar, Valeiras Soledad, Lorenzatti C Gimena, Venero Julián, Garibotto Martín, Hilgert Sebastián, Rubin Uriel, Daponte Andrés, Guillermo Iribarren; OCULAR TOXOPLASMOSIS : Clinical and serological correlation.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2824.
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© ARVO (1962-2015); The Authors (2016-present)
Acute toxoplasmic chorioretinitis is presented as a primary infection or reactivation of a congenital disease. The ocular diagnosis is based on clinical examination and is complemented by serology. Objective: To study the correlation between clinical and serological diagnosis in toxoplasmic coriorretintis .
Methods: Retrospective, data base examination from january 2010to december 2012. ophthalmological criteria: Acute : 1st episode , single chorioretinal inflammatory lesion, activated in the absence of other chorioretinal scar. Reactivated : congenital infection , or acute lesion in the presence of chorioretinal scar or history of similar episodes . Serologic criteria . Acute episode : Sabin -Feldman (SF ) = o > 1:4000 , complement fixation (CF) > 1:10 and / or IgM ( ISAGA technique ) positive. Rectivación episode : Sabin Feldman = or < 1:1000, Fij . CF '= or < 1:10, and IgM negative.
Results : 330 patients were included. Clinical criteria of acute chorioretinitis : 96 , median 39, Male : 39, Fem : 57 OD: 51, OS : 45, bilateral 3. The SF median was 1:16000 (range : 256-64000 ). The recoveries were 234, median 23 years , Male : 93 Fem : 87, OD: 87; OS: 99 and 51 bilateral . SF antibodies : 1:256 median (range 16-16000 ) . The level of mismatch in acute clinical chorioretinitis was 6.25 % (6 /96) . In reactivated mismatch level was 15.3 % (36 /234) .
Conclusion : The medical criteria in acute infection was 94% of corroboration by the laboratory . In two cases, the clinical presentation , had no correlation with serology ,and were interpreted as probably congenital , previous infections in their first episode . Reactivation of active chorioretinitis had clinical infection titles chronic infection in 85% of patients. 15% have medium SF titles from 1:1000 to 1: 4000 and CF until 1:20. The overall rate of clinical / serological coincidence was 87.2 %. This high percentage of overlap allows to estimate with high accuracy the diagnosis of ocular toxoplasmosis . The importance of these is that serological studies should be indicated to confirm the suspected diagnosis but also for monitoring response to treatment and disease
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