Primary Ocular Toxoplasmosis Presenting to Uveitis Services in a Non-endemic Setting
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Purpose: This study sought to describe the different clinical features and presentations of primary ocular toxoplasmosisin a setting not demonstrating an outbreak of disease. Methods: This was a retrospective review of patients presenting to uveitis management services in Aucklandand Hamilton, New Zealand between 2003 to 2018 with uveitis and positive toxoplasmosis immunoglobulin Mserology. Results: We identified 16 patients with primary acquired toxoplasmosis infection and ocular involvement. Themean age was 53 years. Systemic symptoms were reported in 56% (9 / 16). Visual acuity was reduced to 20 /30 or less in 50% of patients (8 / 16). A single focus of retinitis without a pigmented scar was the salient clinicalfeature in 69% (11 / 16). Optic nerve inflammation was the sole clinical finding in 19% (3 / 16). Bilateral arterialvasculitis was the sole clinical finding in 13% (2 / 16). A delay in the diagnosis of toxoplasmosis of more thantwo weeks occurred in 38% (6 / 16) due to an initial alternative diagnosis. Antibiotic therapy was prescribed inall cases. Vision was maintained or improved in 69% (11 / 16) at the most recent follow-up visit (15 months to10 years). Relapse occurred in 69% (11 / 16), typically within four years from the initial presentation. Conclusions: Primary ocular toxoplasmosis presenting in adulthood is a relatively uncommon cause of posterioruveitis in New Zealand. This condition should be considered in any patient presenting with retinitis or opticnerve inflammation without a retinochoroidal scar. This disease tends to relapse; thus, close follow-up is required.
Abstract
Purpose: This study sought to describe the different clinical features and presentations of primary ocular toxoplasmosisin a setting not demonstrating an outbreak of disease. Methods: This was a retrospective review of patients presenting to uveitis management services in Aucklandand Hamilton, New Zealand between 2003 to 2018 with uveitis and positive toxoplasmosis immunoglobulin Mserology. Results: We identified 16 patients with primary acquired toxoplasmosis infection and ocular involvement. Themean age was 53 years. Systemic symptoms were reported in 56% (9 / 16). Visual acuity was reduced to 20 /30 or less in 50% of patients (8 / 16). A single focus of retinitis without a pigmented scar was the salient clinicalfeature in 69% (11 / 16). Optic nerve inflammation was the sole clinical finding in 19% (3 / 16). Bilateral arterialvasculitis was the sole clinical finding in 13% (2 / 16). A delay in the diagnosis of toxoplasmosis of more thantwo weeks occurred in 38% (6 / 16) due to an initial alternative diagnosis. Antibiotic therapy was prescribed inall cases. Vision was maintained or improved in 69% (11 / 16) at the most recent follow-up visit (15 months to10 years). Relapse occurred in 69% (11 / 16), typically within four years from the initial presentation. Conclusions: Primary ocular toxoplasmosis presenting in adulthood is a relatively uncommon cause of posterioruveitis in New Zealand. This condition should be considered in any patient presenting with retinitis or opticnerve inflammation without a retinochoroidal scar. This disease tends to relapse; thus, close follow-up is required.
참고문헌 (17)
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