Antoniazzi E, Guagliano R, Meroni V, Pezzotta S, Bianchi P E
Clinica Oculistica-Università di Pavia-Fondazione I.R.C.C.S. Policlinico S. Matteo.
Parassitologia. 2008 Jun;50(1-2):35-6.
The purpose of this review is to update the latest information about ocular toxoplasmosis. The infection can be congenital or acquired, but also depends about the immune condition of the patient and can affect the eye. Ocular symptoms are variable according to the age of the subject. Retinochoroiditis is the most common manifestation of toxoplasmic infection. Toxoplasmic retinochoroiditis typically affects the posterior pole, and the lesions can be solitary or multiple. Active lesions present as grey-white focus of retinal necrosis with adjacent choroiditis, vasculitis, hemorrhage and vitreitis. Anterior uveitis is a common finding. Atypical presentations include punctate outer retinitis, neuroretinitis and papillitis. Depending on the patient's age and the localization of the lesion, ocular symptoms vary usually presenting with reduced visual acuity or without symptoms. The laboratory diagnosis of toxoplasmosis is based on detection of antibodies and T. gondii DNA using polymerase chain reaction (PCR) which fulfillis clinical findings. Toxoplasmosis therapy includes antimicrobial drugs and corticosteroids. There are several regimens with different drug combinations including, among others, pyrimethamine, sulfadiazine, clindamycin, and trimethoprim-sulfamethoxazol.
本综述的目的是更新有关眼部弓形虫病的最新信息。该感染可以是先天性的或后天获得的,但也取决于患者的免疫状况,并且会影响眼睛。眼部症状因患者年龄而异。视网膜脉络膜炎是弓形虫感染最常见的表现。弓形虫性视网膜脉络膜炎通常累及后极部,病变可以是单个或多个。活动性病变表现为视网膜坏死的灰白色病灶,伴有相邻的脉络膜炎、血管炎、出血和玻璃体炎。前葡萄膜炎是常见表现。非典型表现包括点状外层视网膜病变、视神经视网膜病变和视乳头炎。根据患者年龄和病变部位,眼部症状通常有所不同,表现为视力下降或无症状。弓形虫病的实验室诊断基于抗体检测以及使用聚合酶链反应(PCR)检测弓形虫DNA,这与临床发现相符。弓形虫病治疗包括抗菌药物和皮质类固醇。有几种不同药物组合的治疗方案,其中包括乙胺嘧啶、磺胺嘧啶、克林霉素和甲氧苄啶-磺胺甲恶唑等。