Ocular Toxoplasmosis in a Tertiary Referral Center in Sydney Australia—Clinical Features, Treatment, and Prognosis
Ocular Toxoplasmosis in a Tertiary Referral Center in Sydney Australia—Clinical Features, Treatment, and Prognosis
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澳大利亚悉尼三级转诊中心的眼弓形虫病 — 临床特征、治疗和预后
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
P. McCluskey
中科院分区：
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作者：
Will Yates;Fabian Chiong;S. Zagora;J. Post;D. Wakefield;P. McCluskey
目的：本研究的目的是提供一个回顾性分析的介绍，人口统计学和治疗方案的眼弓形虫病在一个大型三级转诊葡萄膜炎中心。设计：回顾性队列研究。参与者：共有48例眼弓形虫病患者到悉尼眼科医院参加了这项研究。研究方法：这是对2007年至2016年期间在悉尼眼科医院就诊的患者档案的回顾性审查，其临床特征与眼部弓形虫病一致。记录并分析基线风险因素和治疗详情。与其他眼弓形虫病研究相比，主要结果指标为视力和复发率。结果如下：中位年龄为35.5岁（四分位距21-50岁），其中30例（60%）患者既往无症状发作或脉络膜视网膜瘢痕形成证据。就诊时的视力为0.51或6/19（SE 0.096），随访时为0.31或6/12（SE 0.094）。9例患者在观察期间复发，至复发的中位时间为2.2年（SE 0.45），复发率为0.09/人-年。病变主要位于血管弓内（n = 44），9例患者累及黄斑。 大部分患者接受克林霉素治疗（n = 34），乙胺嘧啶和磺胺嘧啶用于黄斑病变。 结论：眼弓形虫病患者与其他已发表的系列相比，复发率较低，视力恢复较好。大多数患者接受克林霉素和口服泼尼松龙，这些药物耐受性良好，而嘧啶和磺胺嘧啶则保留给黄斑病变患者。
Purpose: The aim of this study was to provide a retrospective analysis of the presentation, demographics, and treatment regimens for ocular toxoplasmosis at a large tertiary referral uveitis center. Design: Retrospective cohort study. Participants: A total of 48 patients with ocular toxoplasmosis who presented to Sydney Eye Hospital participated in this study. Methods: This is a retrospective review of patient files who presented to Sydney Eye Hospital between 2007 and 2016 with clinical features consistent with ocular toxoplasmosis. Baseline risk factors and treatment details were recorded and analyzed. Main outcome measures were visual acuity and relapse rate compared with other studies in ocular toxoplasmosis. Results: The median age was 35.5 (interquartile range 21–50) with 30 (60%) patients having no previous symptomatic episodes or evidence of chorioretinal scarring. Visual acuity at presentation was 0.51 or 6/19 (SE 0.096) and at follow-up 0.31 or 6/12 (SE 0.094). Nine patients experienced a recurrence during the period of observation with median time to recurrence 2.2 years (SE 0.45) and the relapse rate was 0.09/person-years. Location of lesion was predominantly within the vascular arcades (n = 44) with macular involvement in 9 patients. Most patients received clindamycin therapy (n = 34) with pyrimethamine and sulfadiazine was used for those with macula involvement. Conclusions: Patients with ocular toxoplasmosis had fewer recurrences compared with other published series and had better visual recovery. The majority of patients received clindamycin and oral prednisolone which were well tolerated with pyrimethazine and sulfadiazine reserved for those with macula-involving disease.