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Mahmoud O Jaroudi, Khalid F Tabbara, Samir S Shoughy, Charbel Bou Chacra; Outcome of Macular Toxoplasmosis Following Treatment. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5281.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the structural and functional outcome of macular toxoplasmosis in a cohort of immunocompetent patients following treatment with antimicrobial agents and steroids.
Retrospective chart review of twelve patients presenting between 2007 and 2012 with ocular toxoplasmosis affecting or involving the macula (anatomic fovea centralis) was done. All patients underwent complete eye examination and received systemic antimicrobial therapy in combination with corticosteroids. Structural and functional response to treatment was assessed over the course of 10 months and documented by Snellen visual acuity test, fundus photos and optical coherence tomography images.
There were four female and eight male patients with a mean age of 34 years (range, 16-54 years). The mean follow-up period after treatment initiation was 10 months (range, 8-12months). All twelve patients showed clinical evidence of improvement in visual acuity and healing of the macular retinochoroiditis within the first 4 weeks of therapy and at 6 months follow-up. Nine patients (75%) had 20/40 visual acuity or better at 6 months follow-up. Ten patients (83%) had a residual macular scar affecting their final vision. However, two patients (12%) who received treatment within the first 12-24 hours of symptoms onset had full resolution of the disease without residual macular scarring and regained 20/20 and 20/18 vision.
Patients with macular toxoplasmosis present earlier than patients with peripheral lesions. Early diagnosis and prompt treatment within the first 12-24 hours of symptoms onset may carry a positive prognostic value. Full resolution of macular toxoplasmic retinochoroiditis without residual scarring and restoration of 20/20 vision can be achieved in patients who are treated early with antimicrobials and steroids.
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