Damms T, Böhnke M, Behrend-Berdin B, Laufs R
Universitäts-Augenklinik, Hamburg, Bundesrepublik Deutschland.
Fortschr Ophthalmol. 1991;88(2):154-7.
The diagnostic value of toxoplasma serology in ocular toxoplasmosis is a controversial issue. Some authors feel that a positive titer indicates nothing more than that the patient had been exposed to Toxoplasma gondii at some stage. Even if in most cases the diagnosis is based on the morphological findings on the fundus, it might sometimes be useful to have an additional serologic evaluation. In a retrospective study we compared the level of antitoxoplasmosis antibodies (measured in a complement fixation test and an immunofluorescence test) in 75 patients with clinically proven ocular toxoplasmosis and 146 patients with uveitis of other origin. In our results we showed that the incidence of positive titers and antibody levels are significantly higher in patient with ocular toxoplasmosis than in other uveitis patient (chi 2-test, Mann-Whitney Willcoxon test, p = 0.05). There was no significant difference between antibody levels in patients with anterior uveitis, posterior uveitis or panuveitis of nontoxoplasmotic origin. No correlation between the antibody levels and amount of retinochorioidal fundus lesions could be found. Based on our results, we conclude that in cases where fundus findings are compatible with ocular toxoplasmosis and a complement fixation or immunefluorescence test is positive, specific antitoxoplasmotic therapy should be started.
弓形虫血清学检查对眼弓形虫病的诊断价值是一个存在争议的问题。一些作者认为,阳性滴度仅表明患者在某个阶段接触过刚地弓形虫。即使在大多数情况下诊断是基于眼底的形态学发现,但有时进行额外的血清学评估可能会有所帮助。在一项回顾性研究中,我们比较了75例临床确诊的眼弓形虫病患者和146例其他病因葡萄膜炎患者的抗弓形虫抗体水平(通过补体结合试验和免疫荧光试验测量)。我们的结果表明,眼弓形虫病患者的阳性滴度发生率和抗体水平显著高于其他葡萄膜炎患者(卡方检验、曼-惠特尼-威尔科克森检验,p = 0.05)。非弓形虫性前葡萄膜炎、后葡萄膜炎或全葡萄膜炎患者的抗体水平之间无显著差异。未发现抗体水平与视网膜脉络膜眼底病变数量之间存在相关性。基于我们的结果,我们得出结论,在眼底检查结果与眼弓形虫病相符且补体结合试验或免疫荧光试验呈阳性的情况下,应开始进行特异性抗弓形虫治疗。