Purchase this article with an account.
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.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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]).
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.
This PDF is available to Subscribers Only