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F Gentile, RB Bigioni, S Carlomusto, EM Vingolo; Congenital Toxoplasmosis, Survey on Clinical Aspects of Newborn Retina Three Years of Follow-Up . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4296.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: to determine, in toxoplasmic previously infected women, incidence of children with congenital toxoplasmosis tha develop manifestation of clinical aspects of true retinochoroiditis, and their impact in vision. Methods: we selected 18 infants with congenital toxoplasmosis (Toxoplasma specific IgM+ presence in the maternal serum during pregnancy): 14 males and 4 females, between 15-days-old and 2-years-old. In our study, after the serological tests, were examined the children’s fundus oculi by indirect binocular ophthalmoscopy Results: at the first visit: eight of 18 patients (44%) had normal fundus oculi, 38% had an unpigmented changes, 11% (only females) salt and pepper pigmentation and 5,5% diffused pigmentation. The natural history of treated and untreated patients is different: in most cases it became stable in normal, unpigmented or with salt and pepper pigmented fundus oculi, quickly evolving in one patient (in six months he passed from normal fundus oculi to active lesions) or gradually evolving. The variable progression is similar for males and females with same age. Twochildren, two-months-old male and a twenty-days-old female, presented two different clinical aspects: the first patient had a gradual evolution, in approximately thirteen months his unpigmented fundus oculi developed active lesions, while the second patient had in thirty months a progression from normal fundus oculi to salt and pepper pigmentation and stabilized after nine months. The female child, an asymptomatic infant (she hadn’t signs of disease and her fundus oculi was normal), had been treated with pyrimetamine 3 mg.1+sulfadiazine130 mg.2+levofolene7,5 mg.1, alternating with spiramicina during her first year of life (her mother had been treated during pregnancy). The male child, who was born at the eight month of pregnancy, had clinical signs and had not been treated (during the third month of pregnancy his mother had been treated with rovamicina for four weeks). Conclusion: the treatment with pyrimethamine and sulfadiazine for approximately one year can stabilize the clinical aspect in asymptomatic infants. It slows down the progression of retinochoroiditis, because prevents the development of active lesions.
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