Phan Laura, Kasza Kristen, Jalbrzikowski Jessica, Noble A Gwendolyn, Latkany Paul, Kuo Annie, Mieler William, Meyers Sanford, Rabiah Peter, Boyer Ken, Swisher Charles, Mets Marilyn, Roizen Nancy, Cezar Simone, Remington Jack, Meier Paul, McLeod Rima
University of Chicago School of Medicine, Chicago, Illinois 60637, USA.
Ophthalmology. 2008 Mar;115(3):553-559.e8. doi: 10.1016/j.ophtha.2007.06.022. Epub 2007 Sep 6.
To determine the incidence of new chorioretinal lesions in patients with congenital toxoplasmosis who were treated throughout their first year of life.
Prospective longitudinal observation of a cohort.
One hundred thirty-two children were studied as part of the longitudinal observation.
One hundred thirty-two children were treated during their first year of life with pyrimethamine, sulfadiazine, and leucovorin. They had eye examinations at prespecified intervals.
New chorioretinal lesions on fundus examination and fundus photographs.
The mean age (+/- standard deviation) is 10.8+/-5.1 years (range, 0.2-23). One hundred eight children have been evaluated for new chorioretinal lesions. Thirty-four (31%; 95% confidence interval, 23%-41%) of 108 children developed at least one chorioretinal lesion that was previously undetected. These occurred at varying times during their follow-up course. Fifteen children (14%) developed new central lesions, and 27 (25%) had newly detected lesions peripherally. Ten (9%) had more than one occurrence of new lesions developing, and 13 (12%) had new lesions in both eyes. Of those who developed new lesions, 14 children (41%) did so at age 10 or later.
New central chorioretinal lesions are uncommon in children with congenital toxoplasmosis who are treated during their first year of life. This finding contrasts markedly with earlier reports in the literature for untreated children or those treated for only 1 month near birth, in whom new lesions were much more prevalent (>/=82%). Our observation that 14 (41%) of the 34 children with new chorioretinal lesions had occurrences when they were 10 years or older indicates that long-term follow-up into the second decade of life is important in assessing the efficacy of treating toxoplasmosis during infancy.
确定在出生后第一年接受全程治疗的先天性弓形虫病患者中新发脉络膜视网膜病变的发生率。
对一组人群进行前瞻性纵向观察。
132名儿童作为纵向观察的一部分接受研究。
132名儿童在出生后第一年接受了乙胺嘧啶、磺胺嘧啶和亚叶酸的治疗。他们在预定的时间间隔接受眼部检查。
眼底检查和眼底照片上的新发脉络膜视网膜病变。
平均年龄（±标准差）为10.8±5.1岁（范围0.2 - 23岁）。108名儿童接受了新发脉络膜视网膜病变的评估。108名儿童中有34名（31%；95%置信区间，23% - 41%）出现了至少一处先前未检测到的脉络膜视网膜病变。这些病变在随访过程中的不同时间出现。15名儿童（14%）出现了新的中心性病变，27名（25%）在周边出现了新检测到的病变。10名（9%）儿童出现不止一次新发病变，13名（12%）双眼出现新病变。在出现新病变的儿童中，14名（41%）在10岁或更晚时出现。
在出生后第一年接受治疗的先天性弓形虫病儿童中，新的中心性脉络膜视网膜病变并不常见。这一发现与文献中早期关于未治疗儿童或仅在出生时附近治疗1个月的儿童的报道形成鲜明对比，在这些报道中，新病变更为普遍（≥82%）。我们观察到，34名有新发脉络膜视网膜病变的儿童中有14名（41%）在10岁或更大时出现病变，这表明在评估婴儿期弓形虫病治疗效果时，对生命第二个十年进行长期随访很重要。
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