A case of congenital toxoplasmosis with active chorioretinitis. Parasitological and histopathological findings.
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Adolescent↗
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Results for “TOXOPLASMOSIS, OCULAR”
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[Retinal angioma and toxoplasmosis].
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Child↗
A comparative study concerning the treatment of active toxoplasmic retinochoroiditis with argon laser and medication (follow-up 2-9 years).
Thirty-three eyes (i.e. 33 patients) with active toxoplasmic retinochoroiditis were treated and followed up for a 2 to 9 year period. The patients were divided into two groups. The first was treated with laser, while the second received medication. The division into two groups was made in order to discover possible differences between the two groups concerning success rate, time of regression of the lesion recurrences and complications. The study showed the following results: there was no difference as to the rate of overall success between the two groups. The laser produced no result in the cases where the active retinochoroidal lesion was larger than 2 disc diameters. The regression of the active lesion in the laser group was accomplished in 25-50 days, while in the medication group took 50-150 days. Recurrences after treatment were found in both groups. However, the starting point of recurrences differed in each group.
Adolescent↗
Laser photocoagulation around the foci of toxoplasma retinochoroiditis: a descriptive statistical analysis of 35 patients with long-term follow-up.
Thirty-five patients with toxoplasma retinochoroiditis, receiving medical treatment and then treated with laser photocoagulation around the foci, were retrospectively evaluated for the risk of recurrence of the retinochoroiditis with a Kaplan-Meier representation. The recurrence rates with 95% symmetric confidence intervals were: at 1 year, 12.7 + or - 13%, at 2 years, 19.8 + or - 15%; at 3 years, 24.0 + or - 16%; at 4 years, 33.3 + or - 19%; at 5,6 and 7 years, 53.5 + or - 21%; at 8 and 9 years 66. 8 + or - 22%. With the data provided by our series, it is not possible to show the efficacy of laser photocoagulation as a prevention of recurrence in toxoplasma retinochoroiditis. Moreover, because of their heterogeneity, the recurrence rates from the literature cannot provide precise data for a comparison. Concerning the laser-induced thermal damage, the potential therapeutic mechanism of the laser procedure is discussed.
Adolescent↗
Cutaneous manifestations of toxoplasmosis.
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Adult↗
Deterioration of visual function as examined by electroretinograms in Toxoplasma gondii-infected IFN-gamma-knockout mice.
PURPOSE: To investigate by ERG the effects of Toxoplasma gondii infection on the visual function of interferon gamma knockout (GKO) mice, as a model of immunocompromised hosts. METHODS: Susceptible wild-type (WT) C57BL/6 and GKO C57BL/6 mice were infected with five cysts of the avirulent T. gondii perorally. ERGs were recorded before and after the infection. The eyes of WT and GKO mice were enucleated and prepared for histologic studies 4 weeks and 12 days after infection, respectively. RESULTS: The a- and b-waves of ERGs did not change significantly up to 1 month after infection in WT mice, but those of GKO mice were significantly reduced 11 days after infection. Histopathology revealed focal retinitis and vasculitis in WT mice 4 weeks after infection. Mild inflammation and sludging of blood in the retina and choroid were found in GKO mice 12 days after infection, just before death. Cysts were found in the inner nuclear layer, with little disturbance of the surrounding retinal architecture in both WT and GKO mice. CONCLUSIONS: ERG clearly showed deterioration of visual function in GKO but not in WT mice after T. gondii infection. ERG is a sensitive and reliable method for observing activity in mice severely affected with experimental toxoplasmic retinochoroiditis.
Animals↗
Retinochoroiditis associated with congenital toxoplasmosis in children: IgG antibody profiles demonstrating the synthesis of local antibodies.
PURPOSE: Retinochoroiditis is generally diagnosed after the first year of life and the association with congenital toxoplasmosis presents a diagnostic dilemma. The detection of local intraocular specific antibodies could be useful for diagnosis. METHODS: We studied six patients (mean age 7 +/- 5 years) with retinochoroiditis which appeared after the first year of life. Aqueous and serum were analysed by immunoblotting for anti T. gondii IgG to diagnose toxoplasmosis. RESULTS: All serum samples were positive only for anti T. gondii IgG. The retinochoroiditis was active in three patients and inactive in the others. Immunoblot analysis of serum and aqueous from the patients with active lesions showed IgG versus the specific antigen of T. gondii. In the patients with inactive lesions the pattern was the same in the two compartments. In active forms, aqueous and serum Western blot patterns differed in proteins lower than 16kDa and higher than 116kDa: in aqueous the findings were typically positive for 30kDa. CONCLUSIONS: Aqueous humour analysis by the Western blot technique may be useful in the diagnosis of congenital toxoplasmosis. In the present small series, we nevertheless detected different patterns for inactive and active retinochoroiditis, confirming the diagnosis in the latter. Aqueous humour paracentesis may be indicated in a child with active retinochoroiditis with unusual clinical features, appearing after the first year of life, and with no clinical or serological evidence of congenital infection.
Animals↗
The use of continuous pupillary dilatation of a blind born child in the early 8 months, to achieve partial recovery of vision.
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Blindness↗
Upward extension of an atrophic tract of the retinal pigment epithelium associated with congenital macular toxoplasmosis.
PURPOSE: To report an unusual case of gravitational atrophic tract of the retinal pigment epithelium in a 20-year old woman. METHODS: Case Report. RESULTS: The patient had macular cicatricial congenital toxoplasmic chorioretinitis in both eyes. In the right eye, an atrophic tract of the retinal pigment epithelium originating from the upper margin of the macular scar extended upwards toward the retinal periphery. CONCLUSION: The unusual upward direction of the atrophic tract of retinal pigment epithelium may be explained by the in utero head position during the active phase of the chorioretinal disease.
Adult↗
HIV/AIDS and the eye.
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AIDS-Related Opportunistic Infections↗
[Treatment of toxoplasmic chorioretinitis with clindamycin hydrochloride].
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Administration, Oral↗
HLA antigens and toxoplasmic retinochoroiditis.
HLA (Human Leukocyte-A) antigens of 20 patients with toxoplasmic retinochoroiditis were determined by the standard microlymphocyte cytotoxicity test to see if these patients have different immunogenetic backgrounds from the normal controls. The results showed that there were no significant differences between the patients and the normal controls.
Adolescent↗
Hyperpigmentation of the flexures and pancytopenia during treatment with folate antagonists.
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Adolescent↗
Neutrophil collagenolytic activity in patients with Behçet disease.
Studies were made on neutrophil dysfunction in Behçet disease by examining collagenolytic activity in neutrophils. The collagenolytic activity of neutrophil was found to be significantly higher in patients during the attack phase of this disease than in patients during the remission phase, in patients with other forms of uveitis and in normal controls. Collagenase was present in the collagenolytic enzyme, which showed high activity in the attack phase. The molecular weight of this enzyme was similar to that of mammalian neutrophil collagenase.
Adult↗
Serum antibody response to human and bovine IRBP in uveitis.
Interphotoreceptor retinoid binding protein (IRBP) is a 136,000 molecular weight photoreceptor cell protein capable of inducing an experimental autoimmune uveitis (EAU) in susceptible animal strains. The occurrence of serum antibodies against human (Hu) or bovine (Bo) IRBP was investigated in patients with uveitis and healthy controls. A sensitive ELISA detected anti-IRBP in approximately 50% of patients and controls, without apparent differences in the mean level, titre or avidity and irrespective of the origin of the antigen. Although the correlation (p less than 0.001) between anti-HuIRBP and anti-BoIRBP levels in uveitis sera suggested the presence of crossreacting antibodies, these sera also contained antibodies specific for either the human or the bovine antigen. The only difference between patients and controls was the greater ability of antibodies in uveitis sera (p less than 0.05) to recognize a synthetic peptide of HuIRBP, which induces severe EAU in rats. We conclude that autoantibodies to IRBP occur naturally in man and are not increased in patients with uveitis.
Amino Acid Sequence↗
Anticardiolipin antibodies in uveitis.
Anticardiolipin antibodies (ACA) have been described in association with thrombosis and several vascular diseases and may be involved in retinal vasculitis. To investigate this question we tested sera from 86 patients with posterior uveitis and 100 healthy controls for the presence of anticardiolipin antibodies. The antibody was present in 15 patients: in 7 of the patients with acute retinal necrosis (n = 24), in 4 with idiopathic retinal vasculitis (n = 10), 3 with syphilis (n = 6) and in one SLE patient with retinal vasculitis. Ten patients had IgA-type anticardiolipin antibodies, 6 had IgM-type and 4 had IgG-type anticardiolipin antibodies. Anticardiolipin antibodies could not be detected in sera from uveitis patients with Behçet's disease (n = 10), sarcoid (n = 9), toxoplasmosis (n = 7), multiple sclerosis (n = 3) or Birdshot chorioretinopathy (n = 10). Ten of the healthy controls had cardiolipin antibodies of the IgM class. The exact role of these auto-antibodies in the pathogenesis of retinal vasculitis remains to be resolved.
Antibodies, Anticardiolipin↗
Recurrent toxoplasmic retinochoroiditis. Significance of perilesional satellite dark dots seen by indocyanine green angiography.
PURPOSE: To suggest an explanation for the satellite dark dots seen by indocyanine green angiography (ICGA) around the main focus of a toxoplasmic retinochoroiditis. METHODS: The authors analysed the evolution of ICG satellite dark dots in two cases of recurrent toxoplasmic retinochoroiditis receiving anti-toxoplasmic treatment not including corticosteroids. RESULTS: Both patients had a recurrence on the peripheral aspect of scars from previous retinochoroiditis and were treated with pyrimethamine (50 mg/day) and sulfadiazine (4 g/day) for seven weeks. Resolution of satellite ICG dark dots was observed in both cases on the follow-up ICG angiogram performed at the end of treatment. CONCLUSION: Resolution of ICG satellite dark dots after anti-toxoplasmic treatment not including corticosteroids tends to indicate that there is probably an infectious component in these hypofluorescent dots and that they probably do not represent a purely inflammatory perilesional reaction.
Adult↗