Case Series of Toxoplasmosis in a Tertiary Eye Care Centre in South India


ABSTRACT

Purpose:

To examine the spectrum, clinical profile and outcome of patients with toxoplasmosis.

Material & Methods:

Retrospective analysis of case records of 22 patients (26 eyes) diagnosed as toxoplasmosis from 1 Jan 2015 to 31 Dec 2015 was done. Follow up range from 14 to 25 months. Demographic Data, clinical presentation, antibody titre, treatment details, complications and recurrence details were collected from the case records. The diagnosis was based on characteristic clinical features and response to treatment. IgG and IgM antibody titres for toxoplasma were done in feasible cases. All active lesions were treated with anti-toxoplasma drugs (oral trimrthoprim 160 mg + sulfamethoxazole 800 mg twice a day) for 4 to 6 weeks along with systemic steroids (oral prednisolone 1 mg/kg/day) in tapering dose while monitoring the response to treatment. The decision to stop anti-toxoplasma drugs and tapering of steroids was made by treating physician based on the clinical assessment of activity of the lesion. Patients who were lost to follow up were excluded from the study.

Results:

The mean age at presentation was 33.8 years (Range 2 to 64 years). There were 11 males and 11 females. At presentation, BCVA ranged from 6/9 to 1/60. 4 (18.18%) patients had bilateral involvement and 18 (81.8%) patients had unilateral involvement. 10 (38.4%) of 26 lesions were active. 17 (65.4%) eyes had macular lesions, 7 (26.9%) eye had peripheral lesions and 2 (7.7%) eyes had peripapillary lesions. Clinically vitritis was noted in 8 patients, vasculitis was noted in 5 patients, nystagmus was noted in 1 patients, hypopyon uveitis was noted in 1 patients, anterior uveitis was noted in 5 patients, cystoid macular edema was noted in 1 patient, foveal atrophy was noted in 1 patient, glaucoma was noted in 2 patients, complicated cataract was noted in 2 patients, squint was noted in 2 patients. All patients were immunocompetent. 3 patients had IgG titre positive for toxoplasma. Final BCVA ranged from 6/6 to 6/60. No recurrence was noted.

Conclusion:

Titrated anti-inflammatory treatment under oral anti toxoplasma drug cover with clinical monitoring and meticulous follow up are key to success in management of ocular toxoplasmosis.


CONTACT DETAILS

Pankaja Dhoble
Pondicherry, India
Email : pankajadhoble@yahoo.co.in
Cell Phone: +919585194314
Work Phone: +914132618848