Clinical Manifestations of Ocular Toxoplasmosis in Hubei, China: Case Series.

Abstract

Objective: The clinical features, disease course and visual outcomes of toxoplasmosis are less commonly reported in China than in other countries. To reduce misdiagnosis and improve visual function, the clinical characteristics, management and visual outcomes of 13 cases of ocular toxoplasmosis (OT) were described.

Methods: This retrospective study included 14 eyes of 13 patients who were diagnosed with OT in Hubei, China. The clinical characteristics, course of treatment and outcomes are presented. There were 7 males and 6 females.

Results: The main form of OT was retinochoroiditis with vitritis or anterior uveitis. Next-generation sequencing was applied to 3 eyes, and positive results were found in those eyes. Thirteen patients were positive for Toxoplasma gondii IgG antibodies, and 3 of them were also positive for IgM T. gondii antibodies. One patient with acquired immune deficiency syndrome was diagnosed with coinfection with OT and cytomegalovirus, as evidenced by an aqueous humor etiological test. Three patients were misdiagnosed with noninfectious uveitis. Recurrence occurred in 3 eyes during the follow-up periods. One patient who received vitreous implantation of Ozurdex therapy at another hospital before referral relapsed. One patient who received sulfadiazine, azithromycin and glucocorticoid therapy relapsed. One patient who received sulfadiazine therapy experienced relapse. Patients who received clindamycin and sulfadiazine or who received clindamycin only did not experience recurrence during the follow-up period. The best corrected visual acuity was improved in 6 eyes after inflammation resolved.

Conclusions: Primary active retinochoroiditis is the main form of OT in Hubei, China. Timely correct diagnosis on the basis of ocular characteristics and aetiological test results and effective treatment should be adopted to prevent poor visual outcomes and recurrence.