title: Clinical pattern of ocular toxoplasmosis treated in a referral centre in Serbia.
abstract: OBJECTIVE
  To analyze the clinical pattern of ocular toxoplasmosis (OT) in a referral centre in Serbia.
  
  
  METHODS
  The medical records of consecutive patients admitted for OT to the single referral centre for uveitis in Serbia between 2006 and 2010 were retrospectively analyzed. OT was diagnosed on the basis of typical fundus lesions and positive serology for Toxoplasma.
  
  
  RESULTS
  In a total of 457 uveitis patients, OT was the third leading cause, with 59 patients (12.9%). Most OT cases (73%) were monocular. An active primary retinal lesion was observed in 36% and recurrent OT in 64% patients. Localization of lesions was central/paracentral (44%), juxtapapillar (27%), peripheral (19%), and multifocal (10%). Other ocular manifestations of inflammation included vitritis (44%), anterior uveitis (19%), and retinal vasculitis (10%). Complications included choroidal neovascularization in two and exudative retinal detachment with cataract, glaucoma, and cystoid macular oedema in one patient each. The detection of Toxoplasma-specific IgM antibodies in a single patient indicates a low rate of OT concomitant with acute infection. After treatment, the mean best-corrected visual acuity (BCVA) increased significantly. However, 14 (24%) patients ended up legally blind in the affected eye, of which 2 (3%) with bilateral blindness, all with a very poor BCVA (0.047 ± 0.055) at presentation. Visual impairment and treatment outcome were both associated with central localization of lesions (P<0.0001 and P=0.006, respectively).
  
  
  CONCLUSIONS
  OT is a significant cause of posterior uveitis in Serbia. Patients should be aware of the recurring nature of OT and react immediately if symptoms occur.
authors.affiliation: Uveitis Department, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia.
authors.forename: D
authors.initials: D
authors.lastname: Kovačević-Pavićević
authors.forename: A
authors.initials: A
authors.lastname: Radosavljević
authors.forename: A
authors.initials: A
authors.lastname: Ilić
authors.forename: I
authors.initials: I
authors.lastname: Kovačević
authors.forename: O
authors.initials: O
authors.lastname: Djurković-Djaković
mesh_terms: D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D020256:Choroidal Neovascularization / Q000453:epidemiology / Q000276:immunology / Q000469:parasitology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005451:Fluorescein Angiography; D005901:Glaucoma / Q000453:epidemiology / Q000276:immunology / Q000469:parasitology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012163:Retinal Detachment / Q000453:epidemiology / Q000276:immunology / Q000469:parasitology; D012189:Retrospective Studies; D055771:Serbia / Q000453:epidemiology; D041623:Tomography, Optical Coherence; D014122:Toxoplasma / Q000276:immunology; D014126:Toxoplasmosis, Ocular / Q000453:epidemiology* / Q000276:immunology / Q000469:parasitology; D014605:Uveitis / Q000453:epidemiology / Q000276:immunology / Q000469:parasitology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000913:Antibodies, Protozoan; D000981:Antiprotozoal Agents; D007074:Immunoglobulin G; D007075:Immunoglobulin M