title: Intraocular inflammation associated with ocular toxoplasmosis: relationships at initial examination.
abstract: 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.
authors.affiliation: Consultores Oftalmológicos, Buenos Aires, Argentina. emdodds@consultoresoftalmologicos.com
authors.forename: Emilio M
authors.initials: EM
authors.lastname: Dodds
authors.forename: Gary N
authors.initials: GN
authors.lastname: Holland
authors.forename: Miles R
authors.initials: MR
authors.lastname: Stanford
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Willie O
authors.initials: WO
authors.lastname: Siu
authors.forename: Kayur H
authors.initials: KH
authors.lastname: Shah
authors.forename: Ninette
authors.initials: N
authors.lastname: Ten Dam-van Loon
authors.forename: Cristina
authors.initials: C
authors.lastname: Muccioli
authors.forename: Anna
authors.initials: A
authors.lastname: Hovakimyan
authors.forename: Talin
authors.initials: T
authors.lastname: Barisani-Asenbauer
mesh_terms: 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
chemical_list: D000981:Antiprotozoal Agents; D007166:Immunosuppressive Agents