Presentation of 30 cases of recurrent retinochoroiditis

Abstract

Ocular toxoplasmosis is a pathology that usually presents with non-evolving retinochoroidal lesions; however reactivations or recurrences are possible due to immunosuppressive diseases such as AIDS, neoplasms, drug treatments, due to hormonal factors typical of puberty, associated with pregnancy and even for unknown reasons. Toxoplasma gondii is an intracellular cosmopolitan parasite that affects numerous hosts and in its evolutionary cycle leaves cysts that remain viable, in tissues such as the brain and the retina, which can be reactivated; the reproduction of Toxoplasma initiates a new cycle of eye injuries with serious compromise that can lead to loss of vision.

The objective of the presentation was to report on 30 cases of reactivated retinochoroiditis and their causal relationship.

Presentation of cases: 30 reactivated retinochoroiditis are reported from patients attending the Ophthalmology Service of the Pediatric Hospital of the Child Jesus of the city of Córdoba, Argentina. They were studied through ophthalmological procedures of direct and indirect ophthalmoscopy, fundus biomicroscopy, retinography (RG), retinofluoresceinography (RFG) and by the use of immunological methods; which gave positive results in all cases. The reactivations were related to pregnancy in 1 case, with puberty in 13 cases, with the administration of corticosteroid therapy in 6 cases, with other intercurrent diseases in 7 cases and not attributable to known causes in 3 cases.

Reactivations of toxoplasmosis retinochoroiditis are linked to diseases that cause immunosuppression such as AIDS, corticosteroid treatments, cytostatics, neoplasms. Pregnancy and puberty may be associated with recurrences. A particular situation usually occurs at puberty, in young people without prior diagnosis of toxoplasmosis, or ocular symptoms, but carriers of congenital toxoplasmosis with a reactivation of latent parasitic cysts in the retina leading to complex ocular patology. Therefore, an efficient monitoring of the pregnant woman must be carried out through the methods available for the early diagnosis of congenital toxoplasmosis. Patients with toxoplasmic retinochoroiditis have to receive regular ophthalmological controls due to the possibility of recurrence, in order to receive timely treatment that limits the magnitude of eye damage