Silveira C, Belfort R, Muccioli C, Abreu M T, Martins M C, Victora C, Nussenblatt R B, Holland G N
Clínica Silveira, Erechim, Rio Grande do Sul, Brazil.
Am J Ophthalmol. 2001 Mar;131(3):351-4. doi: 10.1016/s0002-9394(00)00830-8.
To understand better the natural history of ocular toxoplasmosis by reexamining a well-characterized population in Southern Brazil.
Ophthalmological examination and serologic tests for Toxoplasma gondii infection were performed in 1997 on 383 individuals who had undergone the same evaluation in 1990.
Of 109 seronegative subjects in 1990, 21 (19.3%) became seropositive by 1997, and 2 (1.5% of previously seronegative patients; 9.5% of those known to have seroconverted) developed ocular toxoplasmosis. Seroconversion occurred more frequently in individuals under 17 years of age (16 of 46 patients, 34.8%) than in those greater than 17 years of age (5 of 63 patients, 7.9%; p = 0.002). Of 131 seropositive individuals who did not have ocular lesions in 1990, 11 (8.3%) had typical toxoplasmic lesions in 1997. Of the 13 individuals with non-specific hyperpigmented small retinal lesions in 1990, 3 (23%) presented with typical lesions in 1997.
Acquired T. gondii infection can result in late development of ocular lesions. Small, non-specific hyperpigmented retinal lesions may represent sites of T. gondii infection in seropositive individuals.
通过重新检查巴西南部一个特征明确的人群，更好地了解眼部弓形虫病的自然病史。
1997年对1990年接受过相同评估的383人进行了眼科检查和弓形虫感染的血清学检测。
1990年的109名血清阴性受试者中，到1997年有21人（19.3%）血清转为阳性，其中2人（占先前血清阴性患者的1.5%；占已知血清转换者的9.5%）发生了眼部弓形虫病。血清转换在17岁以下个体中更常见（46名患者中有16人，34.8%），高于17岁以上个体（63名患者中有5人，7.9%；p = 0.002）。1990年没有眼部病变的131名血清阳性个体中，11人（8.3%）在1997年出现了典型的弓形虫病变。1990年有非特异性色素沉着性小视网膜病变的13名个体中，3人（23%）在1997年出现了典型病变。
获得性弓形虫感染可导致眼部病变的晚期发生。小的、非特异性色素沉着性视网膜病变可能代表血清阳性个体中弓形虫感染的部位。
