Toxoplasmic Chorioretinitis: Clinical and Therapeutic Aspects: About 16 Cases
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 11
Abstract
1. Abstract: Chorioretinitis is the most common form of uveitis of infectious origin (congenital or the incidence remains limited to about 2% of infected patients, it is the first cause of posterior uveitis in France. a series of 927 patients. The diagnosis of ocular toxoplasmosis is essentially clinical. The evolution is towards healing, the prognosis depends on the location of the lesions: severe in case of macular involvement and favorable in case of peripheral impairment. retrospective study conducted in the ophthalmology department B on a series of 16 cases over a period of 9 years (January 2008-October 2016). The average age is 23.5 years old with extremes of 12 to 35 years.It has a slight female predominance. The attack is unilateral in the majority of patients (87.5%). The average consultation time was 5 days, the decrease in visual acuity was the most frequent sign (100%), myodesopsies (50%), visual fog (25%), redness and eye pain (18%) of cases. Fundus examination revealed chorioretinal foci active in all patients (100%), scarring in 62% of cases, active hyalitis (37%) and retinal serous detachment (37%) with papilledema. in 18% of cases and finally thyndall of CA in only 6% of patients. Angiography was performed in all our patients, the toxoplasmic serology was positive in 87.5%, the PCA was performed in 02 patients with a coefficient of desmonts that is> 3 in one patient and not significant in another. 56% of patients were placed on pyrimethamine + sulfadiazine; it was replaced by azithromycin in 2 patients, sulfamethoxazol + trimethoprim in 25% and one patient under azithromycin. Corticosteroids were associated 48 hours after the start of treatment in 75% of cases. Complete healing of all foci between 4 to 6 weeks. Ocular toxoplasmosis is the leading cause of retinochoroiditis of infectious origin. It is sometimes difficult to differentiate between a congenital and acquired form, this is much more common than we thought. The diagnosis is based on the clinic for typical cases, for atypical cases and severe forms extensively (AIDS, hemopathy, immunodepression ...), the diagnosis is confirmed by the search for a local production of antitoxoplasmic AC or the search for antigens by PCR in aqueous humor or vitreous.It also poses therapeutic difficulties: heavy treatment in the long run that does not prevent frequent recurrence. The visual prognosis of toxoplasmic chorioretinitis depends on the seat and the quality of treatment; relapses are frequent during the evolution. A vaccine is being tested to prevent brain malformations and ocular lesions related to toxoplasmosis.
Authors and Affiliations
Aouatif Masmoudi, Salssabil Nafizy, Samia Nassik, Fatima El Ibrahimi, Amina Berraho
Keywords
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