Abstract
Abstract: :
Purpose: To determinate incidence of toxoplasmosis retinochoroiditis and future visual impact in children after 6 months of congenital negative serology, born from infected women. Methods: Twenty five infants (16 males and 9 females, between 7 days–old and 6 years–old) with congenital toxoplasmosis and negative serology after six months, underwent to fundus examination by indirect binocular ophthalmoscopy. The maternal Toxoplasma specific immunoglobulin M during pregnancy was positive. Results: At the first visit: 15% of patients had normal fundus (grading 0), 45% had an unpigmented fundus (grading 1), 35% salt and pepper pigmentation fundus (grading 2) and 5% diffused pigmentation fundus (grading 3). After one year most patients’fundus became stable in salt and pepper pigmented, normal or diffused pigmentation; it quickly evolving in one patient. The evolution was similar for males and females with the same age. Conclusion: After one year 90% of patients was IgG and IgM negative, however were observed in 55% a gradually evolving of ocular lesions in grading 2 and in 10% active lesions (grading 4). The transient negative toxoplasmosis serology is a frequent phenomenon in children with congenital toxoplasmosis. We believe that the immune–related events lead up to cellular apoptosis resulting an enhancement of retina damage progression. Although the underlying pathophysiological mechanism remains unknown, it is crucial to avoid questioning the initial diagnosis of congenital toxoplasmosis and to continue regular follow–up.
Keywords: toxoplasmosis • retinochoroiditis • immunomodulation/immunoregulation