Clinical Study
Eye (2007) 21, 746–751; doi:10.1038/sj.eye.6702319; published online 31 March 2006
Optic nerve changes in ocular toxoplasmosis
G U Eckert1, J Melamed1 and B Menegaz1
1Department of Ophthalmology, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
Correspondence: J Melamed, Department of Ophthalmology, Medical School, Federal University of Rio Grande do Sul, Rua Cel. Bordini 1614/502, Porto Alegre, RS, CEP: 90440-003, Brazil. Tel/fax: +55 51 3332 4544; E-mail: jmelamed@terra.com.br
Received 2 September 2005; Accepted 29 January 2006; Published online 31 March 2006.
Abstract
Purpose
To determine the prevalence and features of the different types of involvement of the optic nerve in ocular toxoplasmosis.
Methods
Retrospective cross-sectional study. All patients with active ocular toxoplasmosis, consulting in the Uveitis Section of the Ophthalmology Department were selected. The involvement of the optic nerve was classified in the following categories: juxtapapillary retinochoroiditis, pure papillitis, neuroretinitis, distant lesion, and mixed lesion.
Results
The prevalence of involvement of the optic nerve found was 5.3%. The optic nerve involvement with the presence of a concurrent active distant lesion, occurred in 22 eyes (43.1%). A juxtapapillary lesion was found in 18 eyes (35.3%). Eight eyes (15.7%) presented lesions characterised as mixed. Isolated papillitis occurred in 3 eyes (5.9%). Forty-seven lesions (95.9%) were unilateral and two (4.1%) were bilateral. Twenty-eight eyes (54.9%) had pre-existing lesions and 23 (45%) were primary lesions. Visual acuity improved in 35 eyes (71.4%) and remained unchanged in 14 eyes (28.5%).
Conclusion
The involvement of the optic nerve most frequently found in ocular toxoplasmosis was optic nerve oedema with a concurrent distant active lesion. The second type of lesion most often found was juxtapapillary retinochoroiditis. Involvement was monocular in most cases and the visual prognosis was favourable.
Keywords:
ocular toxoplasmosis, papillitis, neuroretinitis, juxtapapillary retinochoroiditis
