Abstract
Purpose :
To describe ocular manifestations and visual outcomes of acute Toxoplasma gondii infection.
Methods :
Individuals who had clinical and serological evidence of acute acquired T. gondii infection with ocular manifestations, seen at the Uveitis Service of Hospital das Clínicas de Ribeirão Preto (Ribeirão Preto, São Paulo, Brazil) from March 2015 to November 2019, were invited to enroll in this prospective study. A uveitis specialist diagnosed ocular toxoplasmosis on the basis of necrotizing retinitis in individuals with serological evidence of acute acquired Toxoplasma infection (T. gondii IgG and IgM positivity) and no evidence of other uveitic etiologies. Subjects were examined by slit-lamp and indirect ophthalmoscopy, and best-corrected visual acuity (BCVA) was recorded at all visits.
Results :
Twenty-seven subjects (56% men, 44% women; n=36 eyes) were included in the study. Twenty-two subjects (81%) were 18-64 years of age and 5 subjects (19%) were ≥65 years of age. Most eyes presented with a single active lesion (n=30; 83%), 5 eyes (14%) had 2-4 active lesions and one eye (3%) had >5 active lesions. Lesions were confined to macula in 14 eyes (39%), extra-macular posterior pole in 4 eyes (11%) and periphery in 10 eyes (28%), and were present in both central and peripheral retina in 8 eyes (22%). Eleven individuals (41%) presented atypical ocular toxoplasmosis, 9 had bilateral active lesions at presentation.
From the total of 36 affected eyes followed for 1 to 50 months (average 16 months), 10 (28%) had final BCVA >20/40, 17 (47%) had final BCVA of 20/40-20/200, and 9(25%) had final BCVA <20/200. Only one individual had final BCVA <20/200 in both eyes. Most eyes with BCVA <20/200 (n=6; 67%) had macular lesions, while the majority of eyes with BCVA >20/40 (n=6; 60%) had peripheral lesions alone.
Conclusions :
Acute toxoplasmosis results in reduced vision in a substantial percentage of affected persons, and presents with atypical manifestations relatively frequently in comparison to recurrent disease.
This is a 2020 ARVO Annual Meeting abstract.