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Paper Information

Journal:   BINA   Spring 2002 , Volume 7 , Number 3; Page(s) 177 To 185.
 
Paper: 

OCULAR TOXOPLASMOSIS: RESPONSE TO TREATMENT AND RISK FACTORS OF RECURRENCE

 
 
Author(s):  MOHAMMADZADEH M., BEHNAZ F., MIRATASHI A.
 
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Abstract: 

Purpose: To determine response to treatment and to identify risk factors of recurrence in ocular toxoplasmosis in Yazd.
Materials and methods: This study is a case series of 164 congenital ocular toxoplamosis patients who had been diagnosed clinically by ophthalmologists and referred to us consecutively for treatment from 1988 to 2001. Fundus examination was done by indirect ophthalmoscopy and 3 mirror lens after routine ocular examination. Weekly eye examination was done after 2 weeks of treatment including sulfadiazine and pyrimethamine and prednisolone. Complete blood counts and platelet counts were obtained every 4 to 10 days. Treatment was continued until a scar was formed and intraocular inflammation had disappeared and 4 days had passed from steroid tapering.
Results: Mean age of patients at the first episode was 20.3±
7.3 years. Among 189 episodes in 164 patients, 134 patients had only active lesions and 30 had both scar and active lesions. Mean and median of improvement were 21 days. Bilateral involvement was seen in 9.1% of the cases. Lesions were more frequent in the posterior pole and superior temporal region. Visual loss in one third of cases was due to peripheral lesions. Before therapy visual acuity of less than 3/10 occurred in 15 patients including 4 legal blindness cases, while after therapy 2 patients had the same visual loss with no legal blindness. Patients with mean duration of therapy of 38 days experienced more relapses than those with mean treatment duration of 42 days. Most relapses occurred within the first year. Delay in diagnosis did not lead to prolonged activity of the disease. One-third of patients needed more than 6 weeks of treatment.
Conclusion: Peripheral lesions should receive enough attention regarding visual loss. Duration of treatment should not be less than 42 days. All patients should better be evaluated at the end of 6 weeks of treatment to detect those who need to receive longer therapy. Vision improves with treatment and all patients need to be followed for at least one year to detect recurrences.

 
Keyword(s): OCULAR TOXOPLASMOSIS, RETINOCHOROIDITIS, RECURRENCES
 
References: 
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