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Ocular Toxoplasmosis in a Tertiary Referral Center in Sydney Australia-Clinical Features, Treatment, and Prognosis.
Asia Pac J Ophthalmol (Phila) 2019 Jul-Aug; 8(4):280-284AP

Abstract

PURPOSE

The aim of this study was to provide a retrospective analysis of the presentation, demographics, and treatment regimens for ocular toxoplasmosis at a large tertiary referral uveitis center.

DESIGN

Retrospective cohort study.

PARTICIPANTS

A total of 48 patients with ocular toxoplasmosis who presented to Sydney Eye Hospital participated in this study.

METHODS

This is a retrospective review of patient files who presented to Sydney Eye Hospital between 2007 and 2016 with clinical features consistent with ocular toxoplasmosis. Baseline risk factors and treatment details were recorded and analyzed. Main outcome measures were visual acuity and relapse rate compared with other studies in ocular toxoplasmosis.

RESULTS

The median age was 35.5 (interquartile range 21-50) with 30 (60%) patients having no previous symptomatic episodes or evidence of chorioretinal scarring. Visual acuity at presentation was 0.51 or 6/19 (SE 0.096) and at follow-up 0.31 or 6/12 (SE 0.094). Nine patients experienced a recurrence during the period of observation with median time to recurrence 2.2 years (SE 0.45) and the relapse rate was 0.09/person-years. Location of lesion was predominantly within the vascular arcades (n = 44) with macular involvement in 9 patients. Most patients received clindamycin therapy (n = 34) with pyrimethamine and sulfadiazine was used for those with macula involvement.

CONCLUSIONS

Patients with ocular toxoplasmosis had fewer recurrences compared with other published series and had better visual recovery. The majority of patients received clindamycin and oral prednisolone which were well tolerated with pyrimethazine and sulfadiazine reserved for those with macula-involving disease.

Authors+Show Affiliations

The University of Sydney, Save Sight Institute, Sydney, Australia. Sydney Eye Hospital, Sydney, Australia.Department of Infectious Diseases, Prince of Wales Hospital, Sydney, Australia. Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.The University of Sydney, Save Sight Institute, Sydney, Australia. Sydney Eye Hospital, Sydney, Australia.Department of Infectious Diseases, Prince of Wales Hospital, Sydney, Australia. Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.School of Medical Sciences, University of New South Wales, Sydney, Australia. NSW Health Pathology, NSW Health, New South Wales, Australia.The University of Sydney, Save Sight Institute, Sydney, Australia. Sydney Eye Hospital, Sydney, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31369405

Citation

Yates, William B., et al. "Ocular Toxoplasmosis in a Tertiary Referral Center in Sydney Australia-Clinical Features, Treatment, and Prognosis." Asia-Pacific Journal of Ophthalmology (Philadelphia, Pa.), vol. 8, no. 4, 2019, pp. 280-284.
Yates WB, Chiong F, Zagora S, et al. Ocular Toxoplasmosis in a Tertiary Referral Center in Sydney Australia-Clinical Features, Treatment, and Prognosis. Asia Pac J Ophthalmol (Phila). 2019;8(4):280-284.
Yates, W. B., Chiong, F., Zagora, S., Post, J. J., Wakefield, D., & McCluskey, P. (2019). Ocular Toxoplasmosis in a Tertiary Referral Center in Sydney Australia-Clinical Features, Treatment, and Prognosis. Asia-Pacific Journal of Ophthalmology (Philadelphia, Pa.), 8(4), pp. 280-284. doi:10.1097/APO.0000000000000244.
Yates WB, et al. Ocular Toxoplasmosis in a Tertiary Referral Center in Sydney Australia-Clinical Features, Treatment, and Prognosis. Asia Pac J Ophthalmol (Phila). 2019;8(4):280-284. PubMed PMID: 31369405.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ocular Toxoplasmosis in a Tertiary Referral Center in Sydney Australia-Clinical Features, Treatment, and Prognosis. AU - Yates,William B, AU - Chiong,Fabian, AU - Zagora,Sophia, AU - Post,Jeffrey J, AU - Wakefield,Denis, AU - McCluskey,Peter, PY - 2019/8/2/pubmed PY - 2019/8/21/medline PY - 2019/8/2/entrez SP - 280 EP - 284 JF - Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) JO - Asia Pac J Ophthalmol (Phila) VL - 8 IS - 4 N2 - PURPOSE: The aim of this study was to provide a retrospective analysis of the presentation, demographics, and treatment regimens for ocular toxoplasmosis at a large tertiary referral uveitis center. DESIGN: Retrospective cohort study. PARTICIPANTS: A total of 48 patients with ocular toxoplasmosis who presented to Sydney Eye Hospital participated in this study. METHODS: This is a retrospective review of patient files who presented to Sydney Eye Hospital between 2007 and 2016 with clinical features consistent with ocular toxoplasmosis. Baseline risk factors and treatment details were recorded and analyzed. Main outcome measures were visual acuity and relapse rate compared with other studies in ocular toxoplasmosis. RESULTS: The median age was 35.5 (interquartile range 21-50) with 30 (60%) patients having no previous symptomatic episodes or evidence of chorioretinal scarring. Visual acuity at presentation was 0.51 or 6/19 (SE 0.096) and at follow-up 0.31 or 6/12 (SE 0.094). Nine patients experienced a recurrence during the period of observation with median time to recurrence 2.2 years (SE 0.45) and the relapse rate was 0.09/person-years. Location of lesion was predominantly within the vascular arcades (n = 44) with macular involvement in 9 patients. Most patients received clindamycin therapy (n = 34) with pyrimethamine and sulfadiazine was used for those with macula involvement. CONCLUSIONS: Patients with ocular toxoplasmosis had fewer recurrences compared with other published series and had better visual recovery. The majority of patients received clindamycin and oral prednisolone which were well tolerated with pyrimethazine and sulfadiazine reserved for those with macula-involving disease. SN - 2162-0989 UR - https://www.unboundmedicine.com/medline/citation/31369405/Ocular_Toxoplasmosis_in_a_Tertiary_Referral_Center_in_Sydney_Australia_Clinical_Features_Treatment_and_Prognosis_ L2 - http://Insights.ovid.com/pubmed?pmid=31369405 DB - PRIME DP - Unbound Medicine ER -