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Monitoring of visual field over 6 months after active ocular toxoplasmosis.
Graefes Arch Clin Exp Ophthalmol 2019; 257(7):1481-1488GA

Abstract

PURPOSE

To prospectively report the perimetric defects during a 6-month follow-up (FU) in patients with initially active ocular toxoplasmosis (OT).

METHODS

Twenty-four patients were studied, including 11 eyes with chorioretinal toxoplasmosis proven with a positive aqueous humor sample and 13 eyes with a biologically unproven, chorioretinal lesion. Automated 24-2 SITA-Standard visual fields were performed at baseline, at the first, and sixth months of FU. A composite clinical severity score was calculated from visual acuity (VA), severity of vitreitis, chorioretinal lesion size, location of the lesion in zone 1, the presence of an initial macular or papillary edema, and long-term scarring. This provided a relative cutoff level of severity. Nine eyes out of the 24 eyes were considered severe (3 unproven and 6 proven OT).

RESULTS

Initial and final visual field parameters (mean deviation [MD] and pattern standard deviation [PSD]) were significantly correlated (r = 0.873; p < 0.001, and r = 0.890; p < 0.001, respectively). During FU, only foveal threshold [FT] was correlated with VA at baseline (r = 0.48; p = 0.01) and at the 6-month FU visit (r = 0.547; p = 0.004). The MD initial predictive value of clinical severity was 0.739 according to the ROC curve. At baseline, severe and nonsevere OT exhibited no significant difference in term of MD (p = 0.06) and PSD (p = 0.1). During the FU, taking into account all the data, MD, PSD, visual function index [VFI], and FT were associated with the severity of toxoplasmosis (p = 0.018, 0.05, 0.016, and 0.02, respectively): the unproven group had a faster recovery of MD during FU (p = 0.05).

CONCLUSION

Visual field parameters better reflected the chorioretinal destruction related to the toxoplasmosis lesion and the functional repercussions than VA alone. Interestingly, MD at presentation could be a discriminating factor of severity in active OT, and each visual field parameter follow-up could be a support to manage patients with active OT, especially in the severe group.

Authors+Show Affiliations

Department of Ophthalmology, University Hospital of Grenoble, Grenoble Alpes University, Cs10217, 38043, Grenoble cedex 09, France. Grenoble Alpes University, F-38041, Grenoble, France.Department of Ophthalmology, University Hospital of Grenoble, Grenoble Alpes University, Cs10217, 38043, Grenoble cedex 09, France. Grenoble Alpes University, F-38041, Grenoble, France. INSERM U1042 Lab Hypoxia and Physiopathology HP2, Grenoble, France.Department of Parasitology, University Hospital, Grenoble, France. INSERM U1209 Institute for Advanced Biosciences UMR CNRS-UGA 5309, Grenoble, France.Department of Ophthalmology, University Hospital, Saint Etienne, France.Department of Ophthalmology, General Hospital, Valence, France.Department of Ophthalmology, General Hospital, Chambéry, France.Department of Internal Medicine, University Hospital, Grenoble, France. INSERM-UGA-CEA-CNRS U1036 Institute for Biosciences, Grenoble, France.Department of Parasitology, University Hospital, Grenoble, France. INSERM U1209 Institute for Advanced Biosciences UMR CNRS-UGA 5309, Grenoble, France.Department of Ophthalmology, University Hospital of Grenoble, Grenoble Alpes University, Cs10217, 38043, Grenoble cedex 09, France. christophe.chiquet@inserm.fr. Grenoble Alpes University, F-38041, Grenoble, France. christophe.chiquet@inserm.fr. INSERM U1042 Lab Hypoxia and Physiopathology HP2, Grenoble, France. christophe.chiquet@inserm.fr.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

31037491

Citation

Blot, J, et al. "Monitoring of Visual Field Over 6 Months After Active Ocular Toxoplasmosis." Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, vol. 257, no. 7, 2019, pp. 1481-1488.
Blot J, Aptel F, Chumpitazi BFF, et al. Monitoring of visual field over 6 months after active ocular toxoplasmosis. Graefes Arch Clin Exp Ophthalmol. 2019;257(7):1481-1488.
Blot, J., Aptel, F., Chumpitazi, B. F. F., Gain, P., Vasseneix, C., Savy, O., ... Chiquet, C. (2019). Monitoring of visual field over 6 months after active ocular toxoplasmosis. Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, 257(7), pp. 1481-1488. doi:10.1007/s00417-019-04313-2.
Blot J, et al. Monitoring of Visual Field Over 6 Months After Active Ocular Toxoplasmosis. Graefes Arch Clin Exp Ophthalmol. 2019;257(7):1481-1488. PubMed PMID: 31037491.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Monitoring of visual field over 6 months after active ocular toxoplasmosis. AU - Blot,J, AU - Aptel,F, AU - Chumpitazi,B F F, AU - Gain,P, AU - Vasseneix,C, AU - Savy,O, AU - Bouillet,L, AU - Pelloux,H, AU - Chiquet,Christophe, Y1 - 2019/04/29/ PY - 2018/07/29/received PY - 2019/04/01/accepted PY - 2019/03/20/revised PY - 2019/5/1/pubmed PY - 2019/6/27/medline PY - 2019/5/1/entrez KW - Ocular toxoplasmosis KW - Scotoma KW - Visual acuity KW - Visual field SP - 1481 EP - 1488 JF - Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie JO - Graefes Arch. Clin. Exp. Ophthalmol. VL - 257 IS - 7 N2 - PURPOSE: To prospectively report the perimetric defects during a 6-month follow-up (FU) in patients with initially active ocular toxoplasmosis (OT). METHODS: Twenty-four patients were studied, including 11 eyes with chorioretinal toxoplasmosis proven with a positive aqueous humor sample and 13 eyes with a biologically unproven, chorioretinal lesion. Automated 24-2 SITA-Standard visual fields were performed at baseline, at the first, and sixth months of FU. A composite clinical severity score was calculated from visual acuity (VA), severity of vitreitis, chorioretinal lesion size, location of the lesion in zone 1, the presence of an initial macular or papillary edema, and long-term scarring. This provided a relative cutoff level of severity. Nine eyes out of the 24 eyes were considered severe (3 unproven and 6 proven OT). RESULTS: Initial and final visual field parameters (mean deviation [MD] and pattern standard deviation [PSD]) were significantly correlated (r = 0.873; p < 0.001, and r = 0.890; p < 0.001, respectively). During FU, only foveal threshold [FT] was correlated with VA at baseline (r = 0.48; p = 0.01) and at the 6-month FU visit (r = 0.547; p = 0.004). The MD initial predictive value of clinical severity was 0.739 according to the ROC curve. At baseline, severe and nonsevere OT exhibited no significant difference in term of MD (p = 0.06) and PSD (p = 0.1). During the FU, taking into account all the data, MD, PSD, visual function index [VFI], and FT were associated with the severity of toxoplasmosis (p = 0.018, 0.05, 0.016, and 0.02, respectively): the unproven group had a faster recovery of MD during FU (p = 0.05). CONCLUSION: Visual field parameters better reflected the chorioretinal destruction related to the toxoplasmosis lesion and the functional repercussions than VA alone. Interestingly, MD at presentation could be a discriminating factor of severity in active OT, and each visual field parameter follow-up could be a support to manage patients with active OT, especially in the severe group. SN - 1435-702X UR - https://www.unboundmedicine.com/medline/citation/31037491/Monitoring_of_visual_field_over_6_months_after_active_ocular_toxoplasmosis L2 - https://dx.doi.org/10.1007/s00417-019-04313-2 DB - PRIME DP - Unbound Medicine ER -