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Sarah Ullah, Mark Goerlitz-Jessen, Ingrid U Scott, esther bowie; Practice Patterns in the Management of Ocular Toxoplasmosis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4511.
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© ARVO (1962-2015); The Authors (2016-present)
Toxoplasmosis is an ubiquitous parasitic infection which is the leading cause of posterior uveitis worldwide. Episodes of acute toxoplasmosis retinochoroiditis (TRC) may lead to permanent visual impairment if the posterior pole is affected or if it is associated with a complication (e.g., retinal detachment). Currently, there are many treatment regimens available for TRC. However, there is no consensus among providers regarding the best treatment modality for ocular toxoplasmosis. The purpose of our study is to describe practice patterns among retina specialists worldwide regarding the treatment of toxoplasmosis. This may aid in the development of guidelines for managing TRC.
The Penn State College of Medicine Institutional Review Board deemed this study to be exempt. An anonymous survey of multiple choice questions was created in REDCap. An e-mail with a description of the study and link to the survey was sent to 607 members of the Retina Society. Reminder emails were sent weekly. The questionnaire included 18 questions related to the initial management of vision and non vision-threatening ocular toxoplasmosis, use of corticosteroids, and the management of recurrences.
To date, 88 (14%) Retina Society members have completed the survey. Of those respondents, 80 (90.9%) reported they treat both vision-threatening and non vision-threatening lesions. The most commonly reported treatment regimen for the initial treatment of vision-threatening lesions is pyrimethamine, sulfadiazine and folinic acid (reported by 24, or 30% of respondents). In contrast, trimethoprim-sulfamethoxazole alone was the preferred initial treatment for non vision-threatening lesions (n=45, or 52.9%). Forty or 47.6% of respondents use corticosteroids in the treatment of ocular toxoplasmosis. The most commonly cited reason for the use of corticosteroids is for vision-threatening lesions (n= 54 or 84.4%). The majority of respondents (n=49 or 58.3%) do not administer prophylaxis in an attempt to reduce recurrence rates of ocular toxoplasmosis. However, when prophylaxis is used, trimethoprim-sulfamethoxazole is the preferred choice (30, 85.7%).
Although there are many modalities available for the treatment of TRC, there is a lack of established evidence-based guidelines. This study highlights the variations in the management of TRC worldwide, and may aid in the development of guidelines for managing TRC.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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