Comparison between the areas of scarred and active toxoplasmic retinochoroiditis.
Journal
Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
12
07
2020
accepted:
04
11
2020
revised:
02
11
2020
pubmed:
26
11
2020
medline:
26
10
2021
entrez:
25
11
2020
Statut:
ppublish
Résumé
To assess the ratio of scarred/active areas of fundus lesions in patients with presumed ocular toxoplasmosis. Retrospective monocentric study of patients with presumed ocular toxoplasmosis seen between May 2004 and February 2018. Patients with a positive anti-Toxoplasma serology presenting characteristic fundus lesions. Cases with images of both baseline active and scarred lesions of the fundus were included. The borders of each active or scarred lesion were delineated on colour photographs by two independent observers and the area of the lesions was calculated using Digimizer 4.2.2 (MedCalc Software, Ostend, Belgium). The interobserver variability of the measures was recorded and their means were used for further calculations. To study the ratio of the area of scarred retinochoroiditis over the area of the baseline active lesion (R). A total of 171 cases (83 males, 88 females) with a mean age of 31.6 ± 13.8 years were included. The average areas of active and scarred retinochoroiditis were, respectively, 1.32 ± 1.59 and 1.79 ± 2.36 optic disc area. The average ratio between scarred and active areas of retinochoroiditis was 1.36 [range 0.54-2.18]. The administration of a systemic treatment [R = 1.25, p = 0.003], the absence of a pre-existing scar [R = 1.05, p < 0.001] and a peripapillary location of the lesion [R = 0.85, p < 0.001] were each significantly associated with smaller scarred/active area ratios. We assessed in a standardized manner the ratio of scarred/active areas of toxoplasmic lesions and showed that the area of scarred lesions was on average slightly larger than the area of active retinochoroiditis.
Sections du résumé
BACKGROUND/OBJECTIVES
To assess the ratio of scarred/active areas of fundus lesions in patients with presumed ocular toxoplasmosis.
SUBJECTS/METHODS
Retrospective monocentric study of patients with presumed ocular toxoplasmosis seen between May 2004 and February 2018. Patients with a positive anti-Toxoplasma serology presenting characteristic fundus lesions. Cases with images of both baseline active and scarred lesions of the fundus were included. The borders of each active or scarred lesion were delineated on colour photographs by two independent observers and the area of the lesions was calculated using Digimizer 4.2.2 (MedCalc Software, Ostend, Belgium). The interobserver variability of the measures was recorded and their means were used for further calculations. To study the ratio of the area of scarred retinochoroiditis over the area of the baseline active lesion (R).
RESULTS
A total of 171 cases (83 males, 88 females) with a mean age of 31.6 ± 13.8 years were included. The average areas of active and scarred retinochoroiditis were, respectively, 1.32 ± 1.59 and 1.79 ± 2.36 optic disc area. The average ratio between scarred and active areas of retinochoroiditis was 1.36 [range 0.54-2.18]. The administration of a systemic treatment [R = 1.25, p = 0.003], the absence of a pre-existing scar [R = 1.05, p < 0.001] and a peripapillary location of the lesion [R = 0.85, p < 0.001] were each significantly associated with smaller scarred/active area ratios.
CONCLUSIONS
We assessed in a standardized manner the ratio of scarred/active areas of toxoplasmic lesions and showed that the area of scarred lesions was on average slightly larger than the area of active retinochoroiditis.
Identifiants
pubmed: 33235345
doi: 10.1038/s41433-020-01290-3
pii: 10.1038/s41433-020-01290-3
pmc: PMC8452670
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2733-2739Informations de copyright
© 2020. The Author(s).
Références
Smit RLMJ, Baarsma GS, de Vries J. Classification of 750 consecutive uveitis patients in the Rotterdam Eye Hospital. Int Ophthalmol. 1993;17:71–6.
doi: 10.1007/BF00942778
Henderly DE, Genstler AJ, Smith RE, Rao NA. Changing patterns of uveitis. Am J Ophthalmol. 1987;103:131–6.
doi: 10.1016/S0002-9394(14)74217-5
Kovačević-Pavićević D, Radosavljević A, Ilić A, Kovačević I, Djurković-Djaković O. Clinical pattern of ocular toxoplasmosis treated in a referral centre in Serbia. Eye. 2012;26:723–8.
doi: 10.1038/eye.2012.20
Winterhalter S, Severing K, Stammen J, Maier AK, Godehardt E, Joussen AM. Does atovaquone prolong the disease-free interval of toxoplasmic retinochoroiditis? Graefes Arch Clin Exp Ophthalmol. 2010;248:1187–92.
doi: 10.1007/s00417-010-1379-9
Delair E, Latkany P, Noble AG, Rabiah P, McLeod R, Brézin A. Clinical manifestations of ocular toxoplasmosis. Ocul Immunol Inflamm. 2011;19:91–102.
doi: 10.3109/09273948.2011.564068
Aleixo ALQ do C, Curi ALL, Benchimol EI, Amendoeira MRR. Toxoplasmic retinochoroiditis: clinical characteristics and visual outcome in a prospective study. PLoS Negl Trop Dis. 2016;10:e0004685.
Rothova A, Meenken C, Buitenhuis HJ, Brinkman CJ, Baarsma GS, Boen-Tan TN, et al. Therapy for ocular toxoplasmosis. Am J Ophthalmol. 1993;115:517–23.
doi: 10.1016/S0002-9394(14)74456-3
Rajapakse S, Chrishan Shivanthan M, Samaranayake N, Rodrigo C, Deepika, Fernando S. Antibiotics for human toxoplasmosis: a systematic review of randomized trials. Pathog Glob Health. 2013;107:162–9.
doi: 10.1179/2047773213Y.0000000094
Stanford MR, See SE, Jones LV, Gilbert RE. Antibiotics for toxoplasmic retinochoroiditis. Ophthalmology. 2003;110:926–32.
doi: 10.1016/S0161-6420(03)00083-6
Pradhan E, Bhandari S, Gilbert RE, Stanford M. Antibiotics versus no treatment for toxoplasma retinochoroiditis. Cochrane Database Syst Rev. 2016;2016:CD002218.
de-la-Torre A, Stanford M, Curi A, Jaffe GJ, Gomez-Marin JE. Therapy for ocular toxoplasmosis. Ocul Immunol Inflamm. 2011;19:314–20.
doi: 10.3109/09273948.2011.608915
Lashay A, Mirshahi A, Parandin N, Riazi Esfahani H, Mazloumi M, Reza Lashay M, et al. A prospective randomized trial of azithromycin versus trimethoprim/sulfamethoxazole in treatment of toxoplasmic retinochoroiditis. J Curr Ophthalmol. 2017;29:120–5.
doi: 10.1016/j.joco.2016.10.002
Bosch-Driessen LH, Verbraak FD, Suttorp-Schulten MSA, van Ruyven RLJ, Klok AM, Hoyng CB, et al. A prospective, randomized trial of pyrimethamine and azithromycin vs pyrimethamine and sulfadiazine for the treatment of ocular toxoplasmosis. Am J Ophthalmol. 2002;134:34–40.
doi: 10.1016/S0002-9394(02)01537-4
Balaskas K, Vaudaux J, Boillat-Blanco N, Guex-Crosier Y. Azithromycin versus sulfadiazine and pyrimethamine for non-vision-threatening toxoplasmic retinochoroiditis: a pilot study. Med Sci Monit. 2012;18:CR296–302.
doi: 10.12659/MSM.882735
Baharivand N, Mahdavifard A, Fouladi RF. Intravitreal clindamycin plus dexamethasone versus classic oral therapy in toxoplasmic retinochoroiditis: a prospective randomized clinical trial. Int Ophthalmol. 2013;33:39–46.
doi: 10.1007/s10792-012-9634-1
Soheilian M, Ramezani A, Azimzadeh A, Sadoughi MM, Dehghan MH, Shahghadami R, et al. Randomized trial of intravitreal clindamycin and dexamethasone versus pyrimethamine, sulfadiazine, and prednisolone in treatment of ocular toxoplasmosis. Ophthalmology. 2011;118:134–41.
doi: 10.1016/j.ophtha.2010.04.020
Soheilian M, Sadoughi M-M, Ghajarnia M, Dehghan MH, Yazdani S, Behboudi H, et al. Prospective randomized trial of trimethoprim/sulfamethoxazole versus pyrimethamine and sulfadiazine in the treatment of ocular toxoplasmosis. Ophthalmology. 2005;112:1876–82.
doi: 10.1016/j.ophtha.2005.05.025
Acers TE. Toxoplasmic retinochoroiditis: a double blind therapeutic study. Arch Ophthalmol. 1964;71:58–62.
doi: 10.1001/archopht.1964.00970010074010
Perkins ES, Schofield PB, Smith CH. Treatment of uveitis with pyrimethamine (daraprim). Br J Ophthalmol. 1956;40:577–86.
doi: 10.1136/bjo.40.10.577
Jeddi A, Azaiez A, Bouguila H, Kaoueche M, Malouche S, Daghfous F, et al. [Value of clindamycin in the treatment of ocular toxoplasmosis]. J Fr Ophtalmol. 1997;20:418–22.
pubmed: 9296037
Borkowski PK, Brydak-Godowska J, Basiak W, Świtaj K, Żarnowska-Prymek H, Olszyńska-Krowicka M, et al. The impact of short-term, intensive antifolate treatment (with pyrimethamine and sulfadoxine) and antibiotics followed by long-term, secondary antifolate prophylaxis on the rate of toxoplasmic retinochoroiditis recurrence. PLoS Negl Trop Dis. 2016;10:e0004892.
Colin J, Harie JC. [Presumed toxoplasmic chorioretinitis: comparative study of treatment with pyrimethamine and sulfadiazine or clindamycin]. J Fr Ophtalmol. 1989;12:161–5.
pubmed: 2695556
Ben Zina Z, Abid D, Kharrat W, Chaker N, Aloulou K, Chaâbouni M. [Interest in treatment with subconjunctival clindamycin in toxoplasmic retinochoroiditis]. Tunis Med. 2001;79:157–60.
pubmed: 11471444
Damms T, Böhnke M, Behrend-Berdin B. [Results of therapy in ocular toxoplasmosis. Comparison of various forms of therapy]. Ophthalmol Z Dtsch Ophthalmol Ges. 1993;90:737–41.
Chodos JB, Habegger-Chodos HE. The treatment of ocular toxoplasmosis with spiramycin. Arch Ophthalmol. 1961;65:401–9.
doi: 10.1001/archopht.1961.01840020403014
Kim SJ, Scott IU, Brown GC, Brown MM, Ho AC, Ip MS, et al. Interventions for toxoplasma retinochoroiditis. Ophthalmology. 2013;120:371–8.
doi: 10.1016/j.ophtha.2012.07.061
Pearson PA, Piracha AR, Sen HA, Jaffe GJ. Atovaquone for the treatment of toxoplasma retinochoroiditis in immunocompetent patients. Ophthalmology. 1999;106:148–53.
Rothova A, Bosch-Driessen LEH, van Loon NH, Treffers WF. Azithromycin for ocular toxoplasmosis. Br J Ophthalmol. 1998;82:1306–8.
doi: 10.1136/bjo.82.11.1306
Holland GN, Buhles WC, Mastre B, Kaplan HJ. A controlled retrospective study of ganciclovir treatment for cytomegalovirus retinopathy. Use of a standardized system for the assessment of disease outcome. UCLA CMV Retinopathy. Study Group. Arch Ophthalmol. 1989;107:1759–66.
doi: 10.1001/archopht.1989.01070020841024
Jasper S, Vedula SS, John SS, Horo S, Sepah YJ, Nguyen QD. Corticosteroids as adjuvant therapy for ocular toxoplasmosis. Cochrane Database Syst Rev. 2017;1:CD007417.