Journal d'ophtalmologie clinique et expérimentale
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Abstrait

Outcome of Macular Toxoplasmosis

Mahmoud O Jaroudi, Samir S Shoughy, Charbel Bou Chacra, Ammar Al Dawalibi and Khalid F. Tabbara

Objective: To assess the structural and functional outcome of macular toxoplasmosis in a cohort of immunocompetent patients following treatment with antimicrobial agents and steroids.
Methods: The medical records of 12 consecutive immunocompetent patients who presented to The Eye Center, Riyadh, Saudi Arabia between 2001 and 2011 with acquired primary or recurrent macular toxoplasmosis were retrospectively reviewed. All patients filled a comprehensive uveitis questionnaire and underwent complete eyeexamination including visual acuity testing, funduscopy, OCT of macula, fundus photos and fluorescein angiography when indicated. Blood was drawn for toxoplasma antibodies and for other serologic work-up. All patients received systemic antimicrobial therapy in combination with corticosteroids. Structural (macular morphology) and functional (visual acuity) response to treatment was assessed and patients were followed up for a mean period of 6 months.
Results: There were 8 male and 4 female patients with mean age of 34 years (range, 16-54 years). All patients showed clinical evidence of improvement in visual acuity and healing of toxoplasmic retinochoroiditis within the first 4 weeks of therapy and at 6 months follow-up. Nine patients (75%) had 20/40 visual acuity or better at 6 months.
Ten (83%) out of the 12 patients had a residual macular scar affecting their final vision. Two patients (17%) who presented early and received treatment within 24 hours of symptoms onset had full resolution of the retinochoroiditis without macular scarring and regained normal vision.
Conclusion: Prompt treatment in macular toxoplasmosis may preserve vision threatening structures and lead to good visual outcome.