Clinical manifestations and visual outcomes associated with ocular toxoplasmosis in a Brazilian population

Author(s)

Arruda, Sigrid ^[1] ; Vieira, Barbara R. ^[1] ; Garcia, Denny M. ^[1] ; Araujo, Michelle ^[1] ; Simoes, Milena ^[1] ; Moreto, Renata ^[1] ; Rodrigues Jr, Murilo W. ; Belfort Jr, Rubens ; Smith, Justine R. ^[2] ; Furtado, Joao M. ^[3]

Affiliation

^[1] Univ Sao Paulo, Ribeirao Preto Med Sch, Div Ophthalmol, Ave Bandeirantes 3900, BR-14049900 Ribeirao Preto, SP - Brazil

^[2] Flinders Univ S Australia, Coll Med & Publ Hlth, Adelaide, SA - Australia

^[3] Rodrigues Jr, Jr., Murilo W., Univ Sao Paulo, Ribeirao Preto Med Sch, Div Ophthalmol, Ave Bandeirantes 3900, BR-14049900 Ribeirao Preto, SP - Brazil

• Document type: Journal article
• Source: SCIENTIFIC REPORTS; v. 11, n. 1 FEB 4 2021.
• Web of Science Citations: 0

Abstract

Ocular toxoplasmosis is the leading cause of posterior uveitis worldwide. We conducted an observational study of 262 consecutive individuals (n=344 eyes) with ocular toxoplasmosis who were followed over a 34-month period. Most subjects were T. gondii IgG+/IgM- (n=242; 92.4%; 317 eyes), and 140 eyes (40.7%) had active lesions. For eyes in which retinal lesions were active at recruitment and best-corrected visual acuity (BCVA) could be measured (n=133), 21.0% (n=28) remained blind (BCVA below 20/400) after inflammation resolved. In these eyes, atypical ocular toxoplasmosis (OR 4.99; 95% CI 1.14-22.85; p=0.0330), macular lesion (OR 9.95; 95% CI 2.45-47.15; p=0.0019) and any complication (OR 10.26; 95% CI 3.82-30.67; p<0.0001) were associated with BCVA below 20/200. For eyes with only inactive lesions at recruitment and BCVA measured (n=178), 28.1% (n=50) were blind. In these eyes, having at least one lesion larger than one disc-diameter (OR 6.30; 95% CI 2.28-22.46; p=0.0013) and macular lesion (OR 5.69; 95% CI 2.53-13.54; p<0.0001) were associated with BCVA below 20/200. Older age (OR 1.02; 95% CI 1.00-1.05; p=0.0493) and active disease at presentation (OR 4.74; 95% CI 1.95-12.91; p=0.0011) were associated with recurrences. Additional clinical attention should be directed towards patients with risk factors for poor visual outcome. (AU)

• FAPESP's process: 17/06680-4 - Occurrence of blindness and visual impairment in patients with ocular toxoplasmosis followed at the Hospital das Clínicas of the Medical School of Ribeirão Preto, University of São Paulo (HCFMRP-USP)
• Grantee: Michelle Rodrigues Araujo
• Support Opportunities: Scholarships in Brazil - Scientific Initiation