Cataracts in congenital toxoplasmosis.
OBJECTIVE
To determine the incidence and natural history of cataracts in children with congenital toxoplasmosis.


METHODS
Children referred to the National Collaborative Chicago-based Congenital Toxoplasmosis Study (NCCCTS) between 1981 and 2005 were examined by ophthalmologists at predetermined times according to a specific protocol. The clinical course and treatment of patients who developed cataracts were reviewed.


RESULTS
In the first year of life, 134 of 173 children examined were treated with pyrimethamine, sulfadiazine, and leukovorin, while the remaining 39 were not treated. Cataracts occurred in 27 eyes of 20 patients (11.6%, 95% confidence interval [7.2%, 17.3%]). Fourteen cataracts were present at birth and 13 developed postnatally. Locations of the cataracts included anterior polar (three eyes), anterior subcapsular (six eyes), nuclear (five eyes), posterior subcapsular (seven eyes), and unknown (six eyes). Thirteen cataracts were partial, nine total, and five with unknown complexity. Twelve cataracts remained stable, 12 progressed, and progression was not known for 3. Five of 27 eyes had cataract surgery, with 2 of these developing glaucoma. Sixteen eyes of 11 patients had retinal detachment and cataract. All eyes with cataracts had additional ocular lesions.


CONCLUSIONS
In the NCCCTS cohort, 11.6% of patients were diagnosed with cataracts. There was considerable variability in the presentation, morphology, and progression of the cataracts. Associated intraocular pathology was an important cause of morbidity.
Arun
Veena
V
Department of Ophthalmology and Visual Sciences, The University of Chicago, Chicago, IL 60637, USA.
Noble
A Gwendolyn
AG
Latkany
Paul
P
Troia
Robert N
RN
Jalbrzikowski
Jessica
J
Kasza
Kristen
K
Karrison
Ted
T
Cezar
Simone
S
Sautter
Mari
M
Greenwald
Mark J
MJ
Mieler
William
W
Mets
Marilyn B
MB
Alam
Ambereen
A
Boyer
Kenneth
K
Swisher
Charles N
CN
Roizen
Nancy
N
Rabiah
Peter
P
Del Monte
Monte A
MA
McLeod
Rima
R
D000293:Adolescent; D000328:Adult; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002386:Cataract / Q000150:complications* / Q000175:diagnosis; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D006801:Humans; D015994:Incidence; D007223:Infant; D002955:Leucovorin; D011739:Pyrimethamine; D013411:Sulfadiazine; D014125:Toxoplasmosis, Congenital / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D000981:Antiprotozoal Agents; D013411:Sulfadiazine; D002955:Leucovorin; D011739:Pyrimethamine