Abstract
Purpose :
To describe the variability of clinical presentation of the ophthalmic manifestations in congenital TORCH infection at a single institution (Queen Sirikit National Institute of Child Health) in Thailand.
Methods :
Retrospective review of medical records of patients diagnosed with congenital TORCH infection between 2012-2016. The birth weight, gestational age, organism of infection, ophthalmic findings, and treatment were recorded.
Results :
146 cases were diagnosed with congenital TORCH infection. There were 76 with congenital cytomegalovirus infection, 29 with congenital toxoplasmosis, 33 with congenital rubella, 3 congenital herpes simplex, 2 with congenital syphilis, 1 congenital hepatitis B virus, and 2 congenital mycobacterium tuberculosis. There were 9 cases with multiple organisms: 3 cases with both CMV and HSV, which mostly presented with severe tractional retina detachment; 1 case with CMV and Rubella had bilateral total retina detachment; 3 cases with combined CMV, toxoplasmosis and HSV presented with macular scar and no active retinitis; 1 case with HSV, CMV and Rubella had severe bilateral occlusive pupil and microphthalmos; and 1 case with TB and Toxoplasmosis infection had active macular retinitis.
All preterm cases had no ROP noted on presentation.
Conclusions :
Congenital TORCH infections, involving multiple organisms, in our study had severe systemic infection and were significant causes of blindness. Ophthalmic manifestations of these infections are variable with an unpredictable presentation that may be unique for each organism. The clinical characteristics of active eye infection are important to recognize and may lead to better identification of the active organisms. This is critical for proper systemic treatment.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.