TIME PATTERNS OF RECURRENCES AND FACTORS PREDISPOSING FOR A HIGHER RISK OF RECURRENCE OF OCULAR TOXOPLASMOSIS. Issue 4 (April 2015)

• Record Type: Journal Article
• Authors: Reich, Michael; Ruppenstein, Mira; Becker, Matthias D.; Mackensen, Friederike
• Is Part Of: Retina. Volume 35:Issue 4(2015:Apr.)
• Publication Date: 2015-04
• Subjects: ocular toxoplasmosis -- posterior uveitis -- prognosis -- recurrences -- treatment -- uveitis; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000000361
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : Purpose: To ascertain time patterns of recurrences and factors predisposing for a higher risk of recurrence of ocular toxoplasmosis. Methods: Retrospective observational case series with follow-up examination. Database of 4, 381 patients with uveitis was used. Data of 84 patients with ocular toxoplasmosis (sample group) could be included. Results: Two hundred and eighty active lesions in the first affected eye were detected. The mean number of recurrences per year was 0.29 (standard deviation, 0.24). Median recurrence-free survival time was 2.52 years (95% confidence interval, 2.03–3.02 years). Risk of recurrence was highest in the first year after the most recent episode (26%) implying a decrease with increasing recurrence-free interval. The risk of recurrence decreased with the duration of disease ( P < 0.001). Treatment of the first active lesion influenced the risk of recurrence ( P = 0.048). Furthermore, the risk of recurrence was influenced by patient age at the time of the first active lesion ( P = 0.021) and the most recent episode ( P = 0.002). Conclusion: A secondary antibiotic prophylaxis could be discussed 1) during the first year after an active lesion has occurred, especially in case of the first active lesion of ocular toxoplasmosis, and 2) in older patients, especially if primarily infected with Toxoplasma gondii at an older age. Abstract : The risk of recurrence of ocular toxoplasmosis is highest in the first year after the most recent episode. The risk of recurrence decreases with increasing recurrence-free interval and is influenced, inter alia, by treatment of the first active lesion, patient age, and duration of disease.