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At least 865 records · Page 48Linked to original sources
PubMed1997

Use of polymerase chain reaction assays of aqueous humor in the differential diagnosis of retinitis in patients infected with human immunodeficiency virus.

We performed polymerase chain reaction (PCR) for detection of cytomegalovirus (CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV), and Toxoplasma gondii DNA in aqueous humor from 15 patients who were infected with human immunodeficiency virus (HIV) and who had retinitis of unclear origin; these patients were selected from among 820 patients evaluated by ophthalmoscopic examination. On the basis of the final response to treatment, CMV, VZV, and T. gondii retinitis was diagnosed in 5, 2, and 4 of the 15 patients, respectively. No final etiologic diagnosis was reached for four patients. All 5 patients with CMV retinitis were CMV DNA-positive. 1 of 2 patients with VZV retinopathy were VZV DNA-positive, and 3 of 4 patients with T. gondii retinitis were T. gondii DNA-positive. All PCR assays of aqueous humor from the four patients without infectious retinitis were negative. PCR assay of aqueous humor is helpful in the etiologic diagnosis of retinitis of unclear origin in HIV-infected patients.

Aqueous Humor↗
PubMed1997

Foodborne outbreaks of human toxoplasmosis.

Two outbreaks of acute toxoplasmosis involving 8 adult patients in Korea were linked to eating uncooked pork. In the first outbreak, 3 patients developed unilateral chorioretinitis within 3 months of eating a meal consisting of raw spleen and liver of a wild pig. In the second outbreak, 5 of 11 soldiers who ate a meal consisting of raw liver of a domestic pig developed lymphadenopathy. All 8 patients had high levels of IgG Toxoplasma gondii antibodies (> or = 1:1024) in the Sabin-Feldman dye test, modified agglutination test incorporating mercaptoethanol, and latex agglutination test. T. gondii IgM antibodies persisted in these patients for several months. Most patients had a favorable response to anti-T. gondii chemotherapy with pyrimethamine and sulfanomides.

Adult↗
PubMed1994

Early and longitudinal evaluations of treated infants and children and untreated historical patients with congenital toxoplasmosis: the Chicago Collaborative Treatment Trial.

Between December 1981 and May 1991, 44 infants and children with congenital toxoplasmosis were referred to our study group. A uniform approach to evaluation and therapy was developed and is described herein along with the clinical characteristics of these infants and children. In addition, case histories that illustrate especially important clinical features or previously undescribed findings are presented. Factors that contributed to the more severe disabilities included delayed diagnosis and initiation of therapy; prolonged, concomitant neonatal hypoxia and hypoglycemia; profound visual impairment; and prolonged, uncorrected increased intracranial pressure with hydrocephalus and compression of the brain. Years after therapy was discontinued, three children developed new retinal lesions (without loss of visual acuity when therapy for Toxoplasma gondii was initiated promptly), and three children experienced a new onset of afebrile seizures. Most remarkable were the normal developmental, neurological, and ophthalmologic findings at the early follow-up evaluations of many--but not all--of the treated children despite severe manifestations, such as substantial systemic disease, hydrocephalus, microcephalus, multiple intracranial calcifications, and extensive macular destruction detected at birth. These favorable outcomes contrast markedly with outcomes reported previously for children with congenital toxoplasmosis who were untreated or treated for only 1 month.

Animals↗
PubMed1981

A selected review of retinal research and study.

Fifty papers were selected from the American and British Journals of Ophthalmology and the Archives of Ophthalmology from July 1978 to June 1979. Topics include retinal pigment epithelium, retinitis pigmentosa, diabetic retinopathy, toxoplasmosis, and histoplasmosis. Also, other retinopathies, maculopathies, retinoblastoma, retrolental fibroplasia, and retinal breaks, holes, and detachments were included.

Adolescent↗
PubMedDate not supplied

Retinal pigment epithelial hyperplasia assuming tumor-like proportions. Report of two cases.

Two patients who had highly elevated pigmented masses associated with a chorioretinal scar were observed clinically for several years. The scar was due to presumed histoplasmosis in one patient and toxoplasmosis in the other. Histopathological examination disclosed choroidal and subretinal masses consisting of hyperplastic retinal pigment epithelium. The difficulty in making the diagnosis of RPE hyperplasia in such instances is discussed.

Choroid↗
PubMed1993

Toxoplasma gondii retinochoroiditis after liver transplantation.

A 48-year-old woman with a previous a liver transplant and a cataract extraction developed a necrotizing retinochoroiditis in her right eye. Vitreous and serum cultures failed to yield a causative organism. As the retinochoroiditis progressed, visual acuity worsened to the point of no light perception, and the eye became blind and painful. An enucleation was performed and histologic examination showed Toxoplasma gondii necrotizing retinochoroiditis. This is the first histologically documented case of T. gondii retinochoroiditis after liver transplantation. The fulminant clinicopathologic appearance of the retinochoroiditis is similar to that previously reported to occur in acquired immune deficiency syndrome (AIDS) and other forms of immunosuppression, unlike the reactivated congenital retinochoroiditis that occurs in immunocompetent patients.

Animals↗
PubMed1995

Interpretation of intraocular and serum antibody levels in necrotizing retinitis.

BACKGROUND: Intraocular antibodies have been measured as a diagnostic aid in necrotizing retinitis but interpretation of results may be difficult. METHODS: Vitreous or aqueous and serum immunoglobulin G antibodies to toxoplasmosis, cytomegalovirus, herpes simplex virus I and II, and varicella zoster virus were subjected to enzyme-linked immunosorbent assay in 27 patients with necrotizing retinitis and 15 control patients. A quotient was derived quantitating the amount of excess antibody in the eye compared to serum. Different interpretative rules were analyzed to determine which yielded the highest sensitivity and specificity. RESULTS: The highest intraocular antibody relative to serum among the 4 antibodies correctly predicted the final clinical diagnosis in 21 of 27 patients, for a sensitivity of 78% and a specificity of 90%. Interpretive rules that relied on a high numeric value of the antibody quotient or did not consider the relative ranking of the four antibody quotients were less sensitive and specific because multiple antibodies were detected in most eyes. The technique was safe and rapid. CONCLUSION: Interpretation of antibody titers in intraocular fluids is facilitated by testing several relevant antibodies and comparing the results. The technique may be helpful to diagnose necrotizing retinitis and to ascertain viral cause in acute retinal necrosis.

Adolescent↗
PubMed1999

Indocyanine green angiography features in toxoplasmic retinochoroiditis.

BACKGROUND: Indocyanine green (ICG) angiography detects the infrared fluorescence of ICG through the retinal pigment epithelium, providing visualization of the choroidal vascular network. The aim of this study was to analyze ICG angiographic features in toxoplasmic retinochoroiditis. METHODS: Indocyanine green angiography was performed according to a standard uveitis angiographic protocol in 28 consecutive patients diagnosed with acute toxoplasmic retinochoroiditis. Indocyanine green angiographic data were compared with fundus color photographs and fluorescein angiography (FA). Evolution of ICG angiographic signs after therapy (pyrimethamine and sulfadiazine with or without a tapering course of oral corticosteroids) was further analyzed. RESULTS: The main focus of retinochoroiditis was hypofluorescent at all phases of the ICG angiogram in 25/28 cases (89%), but late phase (35-45 minutes) ICG hyperfluorescence was seen in three cases, all of which had very superficial retinal involvement. The most striking features, however, were multiple hypofluorescent satellite dark dots (SDD), present in 21/28 cases (75%). In 17 of these 21 patients, hypofluorescent areas were silent on FA and fundus examination. After therapy, SDD disappeared from most of the cases. Furthermore, the hypofluorescence under the main lesion was markedly reduced or disappeared in some cases. CONCLUSIONS: Indocyanine green angiography showed that toxoplasmic retinochoroiditis is a more widespread process than is clinically suspected because it extends beyond the visible lesions. Indocyanine green angiography appears useful in assessing the extent of choroidal involvement and the evolution of lesions. It might become an important follow-up parameter and also may give new insights into the pathophysiology of this disease. Based on the findings gathered so far, ICG angiography appears indicated in the workup and management of toxoplasmic retinochoroiditis.

Acute Disease↗
PubMed1976

Lens surgery with the vitreous infusion suction cutter.

The vitreous infusion suction cutter was used in the removal of congenital and adult cataracts or lens remnants. The instrument may be used through a standard corneoscleral incision or through the pars plana. When a hard nucleus cannot be dispersed, ultrasonic phacofragmentation may be of help. Several brief case illustrations demonstrate the effectiveness of this instrument in lens surgery.

Adolescent↗
PubMed2006

Verteporfin photodynamic therapy for choroidal neovascularization associated with toxoplasmic retinochoroiditis.

PURPOSE: To evaluate the efficacy and safety of verteporfin photodynamic therapy (V-PDT) for young adults and children with subfoveal choroidal neovascularization (CNV) associated with toxoplasmic retinochoroiditis. METHODS: Patients with subfoveal CNV associated with toxoplasmic retinochoroiditis were treated with V-PDT and prospectively followed up. Before V-PDT and during follow-up, patients underwent visual acuity testing, complete ophthalmic examination including color photography, angiography with fluorescein and/or indocyanine green, and optical coherence tomography. The decision to retreat CNV was based on the criteria used in the Treatment of Age-Related Macular Degeneration with Photodynamic Therapy investigation. RESULTS: Eight patients (5 males and 3 females) were treated at a mean age of 15.3 years (range, 5-31 years). CNV was 100% classic or predominantly classic in all study patients. Mean visual acuity increased from 20/225 (range, 20/400 to 20/50) to 20/123 (range, 20/200 to 20/25) during a mean follow-up period of 25 months (range, 5-49 months). Persistent closure of CNV was achieved in all eight patients (mean number of treatments, 1.75). Vascular anastomosis developed in the treated area in two patients, but there was no additional visual loss. No significant adverse effects of V-PDT were observed. CONCLUSION: V-PDT for subfoveal CNV associated with toxoplasmic retinochoroiditis appears to be effective and safe even in young adults and children. However, a longer follow-up is recommended to confirm our observations.

Adolescent↗