Bosch-Driessen L H, Karimi S, Stilma J S, Rothova A
Donders Institute of Ophthalmology, University Hospital Utrecht, The Netherlands.
Ophthalmology. 2000 Jan;107(1):36-40. doi: 10.1016/s0161-6420(99)00013-5.
To report on the clinical course and prognosis of retinal breaks and detachment occurring in patients with ocular toxoplasmosis.
Retrospective cross-sectional observational study.
One hundred fifty consecutive patients with ocular toxoplasmosis.
A review of all records of patients with ocular toxoplasmosis who had consulted our department from 1990 through 1997 was performed.
The presence of retinal detachment or breaks and possible risk factors, such as age, myopia, the interval between the last recurrence of inflammation and the onset of retinal detachment, severity of vitritis, previous treatment methods, and the location of the retinal abnormalities, were analyzed.
We found a frequency of 6% (9/150) for retinal detachment and an additional 5% (7/150) for retinal breaks among our patients with ocular toxoplasmosis. Attacks of active ocular toxoplasmosis preceding the retinal detachment or retinal breaks were characterized by severe intraocular inflammation. The frequency of myopia in our patients with retinal detachment or retinal breaks was significantly higher than in patients with ocular toxoplasmosis without retinal detachment or retinal breaks. The functional prognosis for the patients with retinal detachment was poor; legal blindness (visual acuity < or = 20/200) resulting from retinal detachment occurred in five of the nine patients.
Careful retinal examination in ocular toxoplasmosis is warranted, especially in patients with myopia and severe intraocular inflammation.
报告眼部弓形虫病患者发生视网膜裂孔和视网膜脱离的临床病程及预后。
回顾性横断面观察研究。
150例连续性眼部弓形虫病患者。
对1990年至1997年期间到我院就诊的眼部弓形虫病患者的所有记录进行回顾。
分析视网膜脱离或裂孔的存在情况以及可能的危险因素,如年龄、近视、上次炎症复发至视网膜脱离发作的间隔时间、玻璃体炎的严重程度、既往治疗方法以及视网膜异常的位置。
在我们的眼部弓形虫病患者中,视网膜脱离的发生率为6%(9/150),视网膜裂孔的发生率为5%(7/150)。视网膜脱离或视网膜裂孔之前的活动性眼部弓形虫病发作以严重的眼内炎症为特征。视网膜脱离或裂孔患者的近视发生率显著高于无视网膜脱离或裂孔的眼部弓形虫病患者。视网膜脱离患者的功能预后较差;9例患者中有5例因视网膜脱离导致法定盲(视力≤20/200)。
对于眼部弓形虫病患者,尤其是近视和严重眼内炎症患者,有必要进行仔细的视网膜检查。