June 2020
Volume 61, Issue 7
ARVO Annual Meeting Abstract  |   June 2020
Intraocular Inflammation Associated with Ocular Toxoplasmosis: Risk Factors for Disease Recurrence
Author Affiliations & Notes
  • Grant L Howell
    Ophthalmology, UCLA Jules Stein Eye Institute, Los Angeles, California, United States
  • Michael Reich
    Ophthalmology, Eye Center, Albert-Ludwigs-University Freiberg, Freiberg, Germany
  • Emilio M. Dodds
    Ophthalmology, Consultores Oftalmológicos, Buenos Aires, Argentina
  • Fei Yu
    Ophthalmology, UCLA Jules Stein Eye Institute, Los Angeles, California, United States
  • Ninette ten Dam-van Loon
    Ophthalmology, FC Donders Institute of Ophthalmology, Utrecht, Netherlands
  • Miles R. Stanford
    Ophthalmology, King's College St. Thomas' Campus, London, United Kingdom
  • Christina Muccioli
    Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Talin Barisani-Ausenbauer
    Specific Prophylaxis & Tropical Medicine, Center for Ocular Inflammation & Infection, Medical University of Vienna, Vienna, Austria
  • Nil Celik
    Ophthalmology, University of Heidelberg, Heidelberg, Germany
  • Gary N Holland
    Ophthalmology, UCLA Jules Stein Eye Institute, Los Angeles, California, United States
  • Footnotes
    Commercial Relationships   Grant Howell, None; Michael Reich, None; Emilio Dodds, None; Fei Yu, None; Ninette ten Dam-van Loon, None; Miles Stanford, None; Christina Muccioli, None; Talin Barisani-Ausenbauer, None; Nil Celik, None; Gary Holland, None
  • Footnotes
    Support  Research to Prevent Blindness, Inc. New York, NY.
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 5380. doi:
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      Grant L Howell, Michael Reich, Emilio M. Dodds, Fei Yu, Ninette ten Dam-van Loon, Miles R. Stanford, Christina Muccioli, Talin Barisani-Ausenbauer, Nil Celik, Gary N Holland; Intraocular Inflammation Associated with Ocular Toxoplasmosis: Risk Factors for Disease Recurrence. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5380.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Factors known to influence risk of recurrent toxoplasmic retinochoroiditis include younger age at initial infection; older age at an episode of active disease; and shorter interval since most recent episode of active disease. We sought to determine whether or not the severity of an episode predicts the interval to a subsequent recurrence of disease.

Methods : We utilized a dataset of 210 patients with ocular toxoplasmosis from 7 international sites (North/South America, Europe). Longitudinal information was available for 46 patients with first-observed episodes and next, recurrent episodes of toxoplasmic retinochoroiditis. We compared the following measures of disease severity in the first episode to the interval between resolution of that episode and onset of active retinal disease in the next episode: anterior chamber (AC) cells; vitreous haze; and duration of the first-observed episode.

Results : Median interval between episodes for patients with >1+ AC cells at presentation of the first-observed episode was 323.0 days (range 91.0-788.0 days), while median interval for those with ≤1+ AC cells was 701.0 days (14.0-4288.0 days, p=0.083, Kruskal-Wallace test).Those with >1+ AC cells were more likely to have a recurrence within 2 years than those with ≤1+ cells (odds ratio [OR] 10.0 [95% Confidence interval [CI, 1.13-88.17], p=0.029, Fisher exact test). Neither vitreous haze nor episode duration were significantly associated with intervals between episodes. Patients with AC cells >1+ in the first-observed episode were also more likely to have >1+ cells in the next episode (OR 14.0 [95% CI 1.37-143.6], p=0.020, Fisher exact test), although agreement between severity of the two episodes for individual patients was only mild (Kappa coefficient 0.361 [95% CI 0.054-0-0.667]).

Conclusions : A more severe AC reaction during an episode of toxoplasmic retinochoroiditis is associated with shorter intervals to the subsequent recurrence. There is also a relationship between the severities of intraocular inflammation of two sequential episodes of active disease. Knowledge of risk factors related to recurrences has implications for deciding whether or not to continue anti-parasitic medications after an episode, as secondary prophylaxis against recurrence.

This is a 2020 ARVO Annual Meeting abstract.


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