RESUMO
Ocular toxoplasmosis is the main cause of posterior uveitis worldwide frequently leading to vision loss. In Brazil, the seroprevalence of Toxoplasma gondii infection ranges from 50 to 80% depending of the region studied. The frequency of toxoplasmic retinal scar may reach 18% of the adults in the South of Brazil. Our goal was to determine the frequency of T. gondii DNA in retinas from eye banks from different regions in Brazil. A total of 162 eyes were obtained from eye banks in Manaus (n = 60), Sao Paulo (n = 60), Chapeco (n = 26), and Joinville (n = 16). The retinas were macroscopically analyzed and collected for DNA extraction. Real-time PCR (qPCR) was performed using the T. gondii B1 marker. By qPCR, a higher frequency of T. gondii DNA in the retinas from the eye bank of Joinville (25%) was found when compared to Manaus (5%). The retinas from Sao Paulo and Chapeco were qPCR negative. Clinical examination determined the retina lesions to be compatible with toxoplasmosis in the following frequencies: Joinville (62.5%), Manaus (10%), Sao Paulo (6.7%), and Chapeco (15.4%).
Assuntos
Bancos de Olhos , Retina/parasitologia , Toxoplasma/isolamento & purificação , Adulto , Animais , Brasil , Corioidite/parasitologia , DNA de Protozoário/análise , Humanos , Reação em Cadeia da Polimerase em Tempo Real , Estudos Soroepidemiológicos , Toxoplasma/genética , Toxoplasmose Ocular/parasitologiaAssuntos
Corioidite/tratamento farmacológico , Previsões , Retinite/tratamento farmacológico , Toxoplasmose Ocular/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/administração & dosagem , Anti-Infecciosos/administração & dosagem , Corioidite/parasitologia , Relação Dose-Resposta a Droga , Seguimentos , Humanos , Recidiva , Retinite/parasitologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: Reactivation of toxoplasmic retinochoroiditis is the most frequent form of uveitis in Misiones, Argentina. Fluctuations in the number of patients consulting with this type of uveitis were detected during the last decade. Since the province was consecutively exposed to rainy and dry periods over the last years, we decided to explore whether a relationship between reactivation of toxoplasmic retinochoroiditis and rain might be established according to the data registered during the 2004-2010 period. RESULTS: The frequency of toxoplasmic reactivation episodes increases when precipitation increases (mostly in second and fourth trimesters of each year). Analysis of the independent variables demonstrates that precipitation is a significant predictor of the frequency of reactivation episodes. Although registered toxoplasmic reactivations were more frequent during the third trimester of the year, the association between the third trimester and the reactivation episodes did not reach statistical significance. CONCLUSION: Prolonged and intense rainfall periods were significantly associated with the reactivation of toxoplasmic retinochoroiditis. Changes promoted by this climatic condition on both the parasite survival in the soil as well as a putative effect on the host immune response due to other comorbidities are discussed.
Assuntos
Corioidite/epidemiologia , Chuva , Retinite/epidemiologia , Toxoplasmose Ocular/epidemiologia , Toxoplasmose Ocular/etiologia , Adulto , Argentina/epidemiologia , Corioidite/parasitologia , El Niño Oscilação Sul , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Retinite/parasitologia , Estações do Ano , Adulto JovemRESUMO
Clinical manifestations of ocular toxoplasmosis are reviewed. Findings of congenital and acute acquired ocular toxoplasmosis include retinal scars, white-appearing lesions in the active phase often associated with vitritis. Complications can include fibrous bands, secondary serous or rhegmatogenous retinal detachments, optic neuritis and neuropathy, cataracts, increased intraocular pressure during active infection, and choroidal neovascular membranes. Recurrences in untreated congenital toxoplasmosis occur in teenage years. Manifestations at birth are less severe, and recurrences are fewer in those who were treated promptly early in the course of their disease in utero and in the first year of life. Severe retinal involvement is common at diagnosis of symptomatic congenital toxoplasmosis in the United States and Brazil. Acute acquired infections also may be complicated by toxoplasmic retinochoroiditis, with recurrences most common close to the time of acquisition. Suppressive treatment can reduce recurrent disease.