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[Results of vitrectomy in children].

Presented are the results of vitrectomy in children operated in the Ophthalmological Department of Children Health Centre. The procedure was preformed in 110 eyes including 32 vitrectomies and 78 vitrectomies connected with lensectomy. Operated were eyes with chronical uveitis of various etiology, with posttraumatic changes, after vitreal haemorrhages in Eales' disease, in persistent vitreal artery cases. Improvement of the visual acuity was achieved in 68 cases (61.8 p.c.), deterioration was observed in 28 (25.5 p.c.); the visual acuity did not change in 14 cases (12.7 p.c.). Retinal detachment was the most frequent complication--38 cases (34.5 p.c.); from this number 10 cases (9 p.c.) improved after a repeated operation.

Child↗
PubMed1991

[One thing begets another].

In this article the signs and symptoms as well as the course and complications are described of a feverish disease contracted by a fourteen year old boy after spending summer-holidays in the southern part of France. In retrospect this disease could be diagnosed as 'Mediterranean spotted fever' In the same period of these manifestations also a partial loss of sight at one eye occurred; although serology tests of antibody titers were negative, it was attributed to chorioretinitis due to activation of a congenital toxoplasmosis. The course was further complicated by an acute renal insufficiency during treatment of the chorioretinitis with high doses sulfadiazine. A short contemplation on the various clinical syndromes is presented.

Acute Kidney Injury↗
PubMed1991

Laboratory diagnosis of toxoplasmosis.

Toxoplasmosis is usually diagnosed in the clinical laboratory by detecting antibodies to Toxoplasma gondii, and only rarely by isolating the parasites. A number of serologic tests are used; each has its own advantages and disadvantages. The methods of diagnosis and their interpretations differ for each clinical category of infection.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[The eye manifestations in chronic postencephalitic congenital toxoplasmosis].

It is presented the examination of a child of 6 months old with microcephaly, delay in the psychomotor development, cerebral calcifications hepatosplenomegaly, sequellae of the chronic congenital Toxoplasma. The child has a bilateral cicatrised macular chorioretinopathy with sistagnus and divergent strabismus at the left eye. The clinical aspects of the chronic congenital postencephalitic toxoplasma is so clear for the oculist.

Chronic Disease↗
PubMed1991

Rhegmatogenous retinal detachments in patients with AIDS and necrotizing retinal infections.

Rhegmatogenous retinal detachments can occur in patients with acquired immune deficiency syndrome (AIDS) and necrotizing retinal infections. Of 68 patients with AIDS and necrotizing retinal infections seen between 1983 and 1987, rhegmatogenous retinal detachments developed in 16 patients (27 eyes). In this group, cytomegalovirus retinopathy was present in 75% (12 of 16) of patients, 18.8% (3 of 16) had probable herpes simplex virus retinopathy, and 6.2% (1 of 16) had toxoplasmic retinochoroiditis. Retinal detachment was bilateral in 68.8% (11 of 16) of patients. The retina was reattached successfully in 91% (10 of 11) of operated eyes. Proliferative vitreoretinopathy was present preoperatively in 95% of these eyes. Seven of 11 operated eyes had initial improvement in visual acuity. However, 5 of 11 continued to lose vision despite successful reattachment. Techniques included pneumatic reattachment, scleral buckle, vitrectomy, and silicone oil injection. Complicated retinal detachments in AIDS patients with rhegmatogenous retinal detachments and necrotizing retinal infections are common and can be repaired, but the prognosis is guarded in many patients.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Prevalence of congenital and acquired toxoplasmic uveitis as evidenced by two serologic methods.

Anti Toxoplasma antibodies were sought in 34 patients with uveitis and 20 healthy individuals by IHAT and IFAT. The total sero-positivity rate was 26.5%. The prevalence was significantly higher among patients with posterior (42.9%) than with anterior uveitis (7.1%) and control (10%) indicating significant role of Toxoplasma as an aetiologic agent of posterior uveitis. 14.4% of patients with seropositive uveitis were considered to be due to primarily acquired Toxoplasma infection as evidenced by their significant higher IFAT mean titre (576.7 +/- 322.1) than IHAT (48 +/- 18.5). The reported toxoplasmic anterior uveitis case is most probably secondary to posterior involvement.

Adult↗
PubMed1991

[Endogenous posterior uveitis and toxoplasma infection: a case-control study].

The present study was first carried out to evaluate the effects of toxoplasma infections on endogenous posterior uveitis in Tian in city. In this report, 118 cases of endogenous posterior uveitis and 236 clinical and health controls were studied by 1:2 pair match case-control method. The clinical controls were OPD patients without uveitis and the health controls were normal persons. The prevalence rate of toxoplasma infection in three groups were 31.4%, 11.9% and 9.3% respectively. The differences of three groups was higher significant. The odds ratio (OR) of toxoplasma infection in posterior uveitis was 3.72 (2.17-6.39). The difference of the two controlled groups was not significant. The odds ratio of toxoplasma infection in central exudative retinochoroiditis and panuveitis were 4.78 and 3.33. The toxoplasma infection was not significantly related to the optic retinitis. The results suggest that toxoplasma infection as a suspect agent of endogenous posterior uveitis.

Case-Control Studies↗
PubMed1990

[Treatment of toxoplasmosis. The treatment of toxoplasmic chorioretinitis].

Toxoplasmosis is the commonest cause of inflammatory disease of the posterior segment of the eye. We treated 23 patients with acute toxoplasma chorioretinitis with sulfonamides, pyrimethamine and corticosteroids for a period of 4 weeks. All patients with acute disease had characteristic foci and a positive titer on the Sabin-Feldman dye test. In all patients, we observed clinical improvement within 2 weeks, but one patient with a lesion larger than 2 disc diameters improved after the third week. During the follow-up period ranging from 6 months to 6 years (mean 2.5 years), there have been four recurrences (17%). No serious side effects of treatment were observed in our patients.

Adolescent↗
PubMed1990

[Congenital toxoplasmosis].

Congenital toxoplasmosis is characterized by the classical triads: hydrocephaly, chorioretinitis and intracerebral calcifications. In fact it is an uncommon manifestation of congenital infection with the parasite Toxoplasma gondii, that is generally subclinical in the neonatal period. But there is a substantial risk of delayed clinical manifestation due to exacerbation of infection: chorioretinitis with loss of vision. With some case histories the interpretation of serodiagnostic techniques is explained and the necessity of repeated tests up to the age of one year in order to exclude a congenital infection definitely, is emphasized.

Female↗
PubMed1990

Toxoplasmic chorioretinitis and hepatic granulomas.

A 71-yr-old male presented with a 2-month history of fever, malaise, and weight loss. Physical exam revealed chorioretinitis. Laboratory studies were notable for elevated levels of alkaline phosphatase, gamma-glutamyl transpeptidase, aspartate transaminase, and alanine transaminase. Immunoglobulin G antibody to Toxoplasma gondii was positive to a dilution of 1:4096, whereas serologic studies for hepatitis A virus, hepatitis B virus, cytomegalovirus, Epstein-Barr virus, human immunodeficiency virus, Brucella, and Tularemia were negative. A percutaneous biopsy of the liver revealed hepatic granulomas. Culture of the biopsy specimen was negative for growth of mycobacteria or fungi. Spontaneous improvement in clinical and laboratory parameters occurred over a 4-month period.

Aged↗
PubMed1990

[Congenital developmental anomalies of the visual system in children in our 13-year observations].

Cases of congenital anomalies of the visual system in children hospitalized in the period 1974-1986 were analyzed. Together 305 cases were analyzed. The most frequently seen congenital anomaly was an unilateral or bilateral cataract (107 cases), further glaucoma (50 cases) and pathological changes caused by Toxoplasma Gondii (33 cases). Among principal causes of these anomalies the author ++ is citing the rubella and toxoplasmosis.

Cataract↗
PubMed1990

Aqueous humor interleukin-6 levels in uveitis.

The level of Interleukin-6 (IL-6) in the aqueous humor of 24 patients with 2 types of uveitis was measured with a specific bioassay using the murine hybridoma cell line B9. Sixteen patients had Fuchs' heterochromic cyclitis (FHC) and 8 had toxoplasma uveitis (TU). Sixty-three percent of each of the FHC and TU groups had raised levels of IL-6 in their aqueous (mean: 543 and 19,228 units/ml respectively). Thirteen control aqueous samples, obtained at surgery for senile cataract, showed IL-6 levels of less than 10 units/ml. Serum obtained at the same time as each aqueous humor sample also showed IL-6 levels of less than 10 units/ml, indicating that the raised levels of IL-6 found in the aqueous of uveitis patients did not result from serum leakage, but from local production. This is the first report on intraocular IL-6 levels, and indicates that IL-6 may play a role as an inflammatory mediator in uveitis.

Adolescent↗
PubMed1990

[Bilateral traction detachment in necrotizing retinitis as a sequela of toxoplasmosis].

A 35-year-old patient with systemic lupus erythematodes is presented. Two weeks after initiation of an immunosuppressive therapy with steroids and cyclophosphamide she developed a bilateral acute necrotising retinitis. Although the infiltration of the vitreous body was only slight the right eye developed a traction retinal detachment within a few days. A vitrectomy was performed but the situation was found to be inoperable due to central necrotic areas. Two days later serological specimen revealed an acute toxoplasmosis as the cause of the bilateral retinitis in this patient. A therapy with sulfadiazine and pyrimethamine was started immediately. Nevertheless two weeks later traction retinal detachment occurred also in the left eye. A reattachment of the retina could be achieved by vitreoretinal surgery.

Adult↗
PubMed1990

Antitoxoplasma antibody in clinically suspected cases of human toxoplasmosis.

(1) Seventy sera from a variety of patients suffering from different diseases suspected to be caused by Toxoplasma gondii infection and forty from non-toxoplasmic hospital cases and laboratory and hospital staff were collected. (2) Antitoxoplasma antibody was detected in those sera by Indirect Haemagglutination test (IHA test) and Enzyme Linked Immunosorbent Assay (ELISA). (3) Twenty one (30%) sera out of 70 test samples and 2 (5%) out of 40 control samples were positive by ELISA test. With IHA test only 17 (24.3%) of test samples and same 2 (5%) of control samples were positive. (4) Sera collected from Paediatric Department showed the highest positivity (40%) followed by Opthalmological group (35.7%) and obstetrics and Gynaecological group (13.6%). (5) No significant co-relation was found between the seropositivity with sex, diet and history of cat contact of the patients.

Animals↗
PubMed1978

[Toxoplasmosis].

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Female↗