Holliman R E, Stevens P J, Duffy K T, Johnson J D
PHLS Toxoplasma Reference Laboratory, St. George's Hospital, London.
Br J Ophthalmol. 1991 Jun;75(6):353-5. doi: 10.1136/bjo.75.6.353.
The limitations of serological assessment in toxoplasma infection of the eye are well recognised, but the predictive value of clinical examination is not defined. We undertook a prospective investigation into the role of clinical examination and of serological findings in cases of suspected toxoplasma infection of the eye by means of the dye test and multiple IgM assays. Seventy-four cases of retinal disease and 202 control patients were studied. Patients with retinal disease had a significantly higher incidence of toxoplasma seropositivity than the control group. This was because some patients with retinal disease had acquired the infection congenitally. Half the patients investigated for toxoplasmosis were seronegative. Possible explanations for these findings included misdiagnosis, clinical uncertainty, or, the use of serology testing in the confirmation of other diseases. An excess of IgM reactivity among the retinal disease group may indicate low level immunoglobulin-M production associated with an acute exacerbation of ocular toxoplasmosis. There is a need to consider invasive procedures in cases of ocular infection and for novel techniques to aid the diagnosis of toxoplasma retinochoroiditis.
血清学评估在眼部弓形虫感染中的局限性已得到充分认识，但临床检查的预测价值尚不明确。我们通过染色试验和多种IgM检测方法，对临床检查和血清学检查结果在疑似眼部弓形虫感染病例中的作用进行了前瞻性研究。研究了74例视网膜疾病患者和202例对照患者。视网膜疾病患者的弓形虫血清阳性率显著高于对照组。这是因为一些视网膜疾病患者是先天性感染。接受弓形虫病调查的患者中有一半血清学检测呈阴性。这些发现的可能解释包括误诊、临床不确定性，或者在其他疾病确诊中使用血清学检测。视网膜疾病组中IgM反应性过高可能表明与眼部弓形虫病急性加重相关的低水平免疫球蛋白M产生。对于眼部感染病例，有必要考虑采用侵入性检查方法，并采用新技术辅助诊断弓形虫性视网膜脉络膜炎。
