Intraocular inflammation associated with ocular toxoplasmosis: relationships at initial examination.
OBJECTIVE
To describe characteristics of intraocular inflammation in eyes with active ocular toxoplasmosis and to identify relationships between signs of inflammation, complications (including elevated intraocular pressure [IOP]), other disease features, and host characteristics.


METHODS
Multicenter, retrospective, cross-sectional study.


METHODS
We reviewed the medical records of 210 patients with toxoplasmic retinochoroiditis at seven international sites (North America, South America, and Europe) for information from the first examination at each site during which patients had active retinal lesions. Signs of inflammation included anterior chamber (AC) cells and flare and vitreous humor cells and haze. Retinal lesion characteristics included size (< or =1 disc area [DA] or >1 DA) and presence or absence of macular involvement.


RESULTS
AC cells and flare were related to vitreous inflammatory reactions (P < or = .041). One or more signs of increased inflammation were related to the following factors: older patient age, larger retinal lesions, and extramacular location. In 30% of involved eyes, there was evidence of elevated IOP (despite use of glaucoma medications by some patients); other complications were uncommon. IOP of more than 21 mm Hg was associated with both increased AC cells and elevated flare (both P < or = .001) and with macular involvement (P = .009). Inflammation seemed to be more severe among patients in Brazil than among those at other sites.


CONCLUSIONS
There is substantial variation between patients in the severity of intraocular inflammation associated with ocular toxoplasmosis, attributable to multiple host- and disease-related factors. Results suggest that disease characteristics also vary in different areas of the world. Elevated IOP at initial examination reflects the severity of inflammation.
Dodds
Emilio M
EM
Consultores Oftalmológicos, Buenos Aires, Argentina. emdodds@consultoresoftalmologicos.com
Holland
Gary N
GN
Stanford
Miles R
MR
Yu
Fei
F
Siu
Willie O
WO
Shah
Kayur H
KH
Ten Dam-van Loon
Ninette
N
Muccioli
Cristina
C
Hovakimyan
Anna
A
Barisani-Asenbauer
Talin
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000867:Anterior Chamber / Q000276:immunology / Q000473:pathology; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002648:Child; D002825:Chorioretinitis / Q000175:diagnosis* / Q000188:drug therapy; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007249:Inflammation / Q000175:diagnosis / Q000188:drug therapy; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis; D012189:Retrospective Studies; D014126:Toxoplasmosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy; D014822:Vitreous Body / Q000276:immunology / Q000473:pathology; D055815:Young Adult
D000981:Antiprotozoal Agents; D007166:Immunosuppressive Agents