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    Ocular Toxoplasmosis: Causative Agent Toxoplasma Gondi An Obligate, Intracellular Parasite

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    henok biruk
    Ocular toxoplasmosis is caused by the parasite Toxoplasma gondii. It commonly causes retinochoroiditis and posterior uveitis. Symptoms include blurred vision, floaters, pain, and photophobia. Risk factors include immunodeficiency, exposure to cats, and eating undercooked meat. Treatment involves combinations of pyrimethamine, sulfadiazine, and corticosteroids to reduce inflammation and minimize damage from recurrence.

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    Ocular Toxoplasmosis: Causative Agent Toxoplasma Gondi An Obligate, Intracellular Parasite

    Uploaded by

    henok biruk
    102 views15 pages
    Ocular toxoplasmosis is caused by the parasite Toxoplasma gondii. It commonly causes retinochoroiditis and posterior uveitis. Symptoms include blurred vision, floaters, pain, and photophobia. Risk factors include immunodeficiency, exposure to cats, and eating undercooked meat. Treatment involves combinations of pyrimethamine, sulfadiazine, and corticosteroids to reduce inflammation and minimize damage from recurrence.

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    ocular toxo

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    Ocular toxoplasmosis is caused by the parasite Toxoplasma gondii. It commonly causes retinochoroiditis and posterior uveitis. Symptoms include blurred vision, floaters, pain, and photophobia. Risk factors include immunodeficiency, exposure to cats, and eating undercooked meat. Treatment involves combinations of pyrimethamine, sulfadiazine, and corticosteroids to reduce inflammation and minimize damage from recurrence.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    102 views15 pages

    Ocular Toxoplasmosis: Causative Agent Toxoplasma Gondi An Obligate, Intracellular Parasite

    Uploaded by

    henok biruk
    Ocular toxoplasmosis is caused by the parasite Toxoplasma gondii. It commonly causes retinochoroiditis and posterior uveitis. Symptoms include blurred vision, floaters, pain, and photophobia. Risk factors include immunodeficiency, exposure to cats, and eating undercooked meat. Treatment involves combinations of pyrimethamine, sulfadiazine, and corticosteroids to reduce inflammation and minimize damage from recurrence.

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    © All Rights Reserved
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    Ocular Toxoplasmosis

    Causative agent Toxoplasma gondi


    An Obligate, intracellular parasite
    It is the Commonest cause of retinochoroiditis and
    posterior uveitis in humans
    Manifest between the 2nd & 4th decades of life

    Risk factors
     Immunodeficiency states
     Exposure to cats
     Eating raw or partially cooked meat

    1
    Ocular Toxoplasmosis
    Symptoms
     Blurred vision
     Floaters
     Pain
     Red eye
     Metamorphopsia
     Photophobia
    Can be acquired or congenital

    2
    Ocular Presentations
    Toxoplasma necrotizing retinochoroiditis
    • Is the Classical presentation of toxoplasmosis involving inner
    retina
    • Surrounded by oedema with contiguous inflammation of choroid
    and sclera
    • May be associated with dense vitritis  "headlight in the fog"
    • May be associated with adjacent focal vasculitis
    •  Also may be associated with Cells and flare in the anterior
    chamber (rarely, mutton-fat keratic precipitates)

    Immunocompetent adults:
     Unilateral, painless and unifocal retinochoroiditis
     Vision good if macula not involved
    Immunocompromised adults:
     Bilateral, multifocal, severe and less vitrous reaction
     May be associated with CNS toxoplasmosis
    3
    Toxoplasma retinochoroiditis
    acute acquired toxo retinochoroiditis in an
    immunocompetent adult

    4
    Toxoplasma retinochoroiditis
    Recurrence over an old scar

    Active
    recurrent
    lesion(white)
    Old scar
    (pigmented)

    5
    Toxoplasma retinochoroiditis
    Active and inactive lesions

    6
    Toxoplasma retinochoroiditis
    Active and inactive lesions

    7
    Toxoplasma Retinochoroiditis
    Congenital toxoplasmosis
    Results from transplacental transmission of T. gondii
    Bilateral and severe
    70% retinochorioditis
    ⅔ macula involved associated with severe visual loss
    Associated with micorophthalmia, vitritis, glaucoma,
    ocular palsies and other severe systemic manifestations

    8
    Other Atypical ocular Manifestations
      
      Retrobulbar neuritis
      Rhegmatogenous retinal detachment
      Pars planitis
      Punctate outer retinitis
      Serous macular detachment
      Panuveitis

     

    9
    Diagnosis
    1. Typical Clinical signs and symptoms
    2. Serologic tests
    Toxoplasma-specific IgG and IgM antibodies(anti-
    toxo IgG and IgM)
    1. IgG
    seroconversion 2-4 weeks after systemic infection, peak
    titres 4-6 weeks after infection
    Titres maintained at high levels for many months or
    years.
    Recent infection : 4x rise in antibody titres over a 2-4
    week period

    Negative anti-toxo IgG excludes ocular toxoplasmosis


    10
    Serological
    2. IgM
    diagnosis
    Less value than IgG
    A positive IgM test indicates recent infection
    A negative IgM test excludes recent toxo infection
    But Toxoplasma-specific IgM antibodies may be
    detected up to 18 months after acute acquired infection

    11
    Treatment
    Pyrimethamine and Sulfadiazine combination
    (Folinic acid needed) with or without systemic
    prednisolone OR
    Cotrimoxazole (Bactrim )(2 tabs bid after loading
    dose) is as effective as pyrimethamine/sulfadiazine for
    lesions outside fovea.
    At least 6 weeks treatment needed
    Corticosteroids
     Topical : depending on AC reaction.
     Depot steroid injection absolutely contraindicated
     Risk of rampant necrosis and blind, phthisical globe
     Systemic steroid adjunct to antibiotics to minimize
    collateral damage from the inflammatory response
     Usually started after antibiotics are given for 3 days
     Prednisolone 1mg/kg po, tapered over 2 weeks
    12
    Treatment
    Other alternative drugs :
    Clindamycine
    Azithromycin + pyrimethamine
    Spiramycin
    Atovaquone (hydroxynaphthoquinone)

    13
    Toxo chorioretinitis before and
    after treatment with
    Bactrim 2 tabs po bid for one month +Prednisolone
    1mg/kg tapered over 2 weeks

    14
    Typical Presentation & Course
    Recurrence
    from past scar

    Inactive
    scar after
    treatment

    15

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