title: Toxoplasmic Retinochoroiditis: Clinical Characteristics and Visual Outcome in a Prospective Study.
abstract: To ascertain the clinical features and visual outcome of toxoplasma retinochoroiditis in a large series of cases.
  
  
  
  Two hundred and thirty subjects diagnosed with active toxoplasma retinochoroiditis were prospectively followed for periods ranging from 269 to 1976 days. All patients presented with active retinochoroiditis and positive IgG T. gondii serology at the beginning of the study and received a standardized drug treatment for toxoplasmosis, both in the first episode and in the subsequent recurrences.
  
  
  
  The group involved 118 (51.3%) men and 112 (48.7%) women, with ages ranging from 14 to 77 years, mean of 32.4 years (SD = 11.38). Primary retinochoroidal lesions were observed in 52 (22.6%) cases and active retinochoroiditis combined with old scars in 178 (77.4%) subjects at the beginning of the study. A hundred sixty-two recurrent episodes in 104 (45.2%) patients were observed during follow-up. New subclinical retinochoroidal lesions were detected in 23 of 162 (14.2%) recurrences episodes during the follow-up. Posterior segment complications were observed in 73 (31.7%) subjects. Retinochoroidal lesions adjacent to the optic nerve and in the macular area were observed in 27 of 40 (67.5%) cases of severe visual impairment (VA = 20/200 or worse).
  
  
  
  Toxoplasma retinochoroiditis in this population had a high recurrence rate after an active episode. Severe visual impairment was associated with location of the retinochoroidal scar, recurrences and posterior segment complications. It is crucial to consider the location of the lesion in studies analyzing visual prognosis as a measure for treatment effectiveness and prevention strategies.
authors.affiliation: Infectious Ophthalmology Laboratory, Evandro Chagas National Institute of Infectious Diseases-FIOCRUZ, Rio de Janeiro, Brazil.
authors.forename: Ana Luisa Quintella do Couto
authors.identifier: 0000-0002-8303-3793
authors.initials: AL
authors.lastname: Aleixo
authors.affiliation: Infectious Ophthalmology Laboratory, Evandro Chagas National Institute of Infectious Diseases-FIOCRUZ, Rio de Janeiro, Brazil.
authors.forename: André Luiz Land
authors.initials: AL
authors.lastname: Curi
authors.affiliation: Infectious Ophthalmology Laboratory, Evandro Chagas National Institute of Infectious Diseases-FIOCRUZ, Rio de Janeiro, Brazil.
authors.forename: Eliezer Israel
authors.initials: EI
authors.lastname: Benchimol
authors.affiliation: Toxoplasmosis Laboratory, Oswaldo Cruz Institute-FIOCRUZ, Rio de Janeiro, Brazil.
authors.forename: Maria Regina Reis
authors.initials: MR
authors.lastname: Amendoeira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000913:Antibodies, Protozoan / Q000097:blood; D002825:Chorioretinitis / Q000188:drug therapy / Q000469:parasitology* / Q000503:physiopathology*; D005123:Eye / Q000469:parasitology / Q000473:pathology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012160:Retina / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology; D014122:Toxoplasma / Q000187:drug effects / Q000276:immunology / Q000302:isolation & purification; D014126:Toxoplasmosis, Ocular / Q000150:complications / Q000188:drug therapy / Q000469:parasitology / Q000503:physiopathology*; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D007074:Immunoglobulin G