Retina-Vitreous
2009 , Vol 17 , Num 4
Prognostic Factors for Final Visual Acuity and Recurrence in Active Ocular Toxoplasmosis
1Ulucanlar Göz Eğitim ve Araştırma Hastanesi Ankara, Uz. Dr.2Ulucanlar Göz Eğitim ve Araştırma Hastanesi Ankara, Doç. Dr.
3Hacettepe Üniversitesi Tıp Fakültesi, Biyoistatistik ve Tıp Bilişimi A.D., Ankara, Uz. Dr.
4Ulucanlar Göz Eğitim ve Araştırma Hastanesi Ankara, Prof. Dr. Purpose: To present ocular features, visual outcome, and efficacy of treatment in patients with ocular toxoplasmosis (OT), and to identify risk factors for visual loss and recurrence.
Materials and Methods: Ocular findings of 60 eyes (60 patients) with active OT followed at Uvea-Behcet Section in Ulucanlar Eye Education and Research Hospital between 1995-2009 were reviewed retrospectively.
Results: The mean follow-up was 27.9 (1-88) months. In 19 patients (31.7%) active lesion was accompanied with typical scar of toxoplasmosis. The most frequent complication was epiretinal membrane (13.3%). Nine different antiparasitic treatments were used in 54 (90%) 54 (90%) patients. Systemic steroids were added in 39 (65%) patients. The treatment had no effect on visual outcome and recurrences (p=0.01). The recurrence was observed in 13 patients (21.7%). Significant relation was found between the recurrence and duration of infection. Moreover, as age of patients and number of scar were increased, and initial visual acuity was decreased, final visual acuity was also decreased. Legal blindness was present in 8 patients (13.3%) in whom the most common cause was macular involvement. Kaplan-Meier survival analysis estimated cumulative risk of recurrence as 54% at 68 months of follow-up.
Conclusion: Although prognosis of OT is commonly satisfactory, it can affect macula and impairs visual acuity. Initial visual acuity, age, and number of scar are detected as risk factors for visual prognosis. Recurrence risk is influenced by duration of infection and increasing during the follow-up. Keywords : Ocular toxoplasmosis, prognosis, recurrence, risk factors, treatment