Reich Michael, Becker Matthias D, Mackensen Friederike
Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany.
Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany Interdisciplinary Uveitis Center, University of Heidelberg, Heidelberg, Germany Department of Ophthalmology, Triemli Hospital, Zürich, Switzerland.
Br J Ophthalmol. 2016 Feb;100(2):195-9. doi: 10.1136/bjophthalmol-2015-306650. Epub 2015 Jul 10.
BACKGROUND/AIMS: Retrospective, observational case series with follow-up examination to analyse the influence of drug therapy on ocular toxoplasmosis (OT) in terms of recurrence-risk.
In this one centre study an existing data set of 84 patients with active OT was used. Drug therapy for 255 active lesions was retrospectively reconstructed. Median recurrence-free survival time was calculated for the different treatment regimes using Kaplan-Meier estimates.
20 different regimens were used as treatment of OT in the catchment area of the Interdisciplinary Uveitis Center, University of Heidelberg, Germany. Median recurrence-free survival time was significantly lower after using systemic corticosteroid monotherapy (0.9 years; 95% CI 0.5 to 1.3 years) compared with Toxoplasma gondii-specific antibiotic treatment (3.0 years; 95% CI 2.2 to 3.9 years; p<0.001) or compared with no therapy (3.0 years; 95% CI 2.1 to 3.9 years; p=0.006). No difference could be detected when comparing median recurrence-free survival time after using T gondii-specific antibiotics compared with no therapy (p=0.679).
Although our study shows that drug therapy seems to influence the risk of recurrence of OT, there is no consensus regarding the choice of antiparasitic agents for treatment regimens in the catchment area of the Interdisciplinary Uveitis Center, University of Heidelberg. Survey results provide useful information for treating physicians and for clinical investigators interested in therapy.
背景/目的:一项回顾性观察性病例系列研究,通过随访检查分析药物治疗对眼部弓形虫病(OT)复发风险的影响。
在这项单中心研究中,使用了一个包含84例活动性OT患者的现有数据集。回顾性重建了255个活动性病变的药物治疗情况。使用Kaplan-Meier估计法计算不同治疗方案的无复发中位生存时间。
在德国海德堡大学跨学科葡萄膜炎中心的服务区域,20种不同的方案被用于OT的治疗。与弓形虫特异性抗生素治疗(3.0年;95%置信区间2.2至3.9年)相比,全身使用皮质类固醇单药治疗后的无复发中位生存时间显著缩短(0.9年;95%置信区间0.5至1.3年);与不进行治疗(3.0年;95%置信区间2.1至3.9年)相比,也显著缩短(p<0.001;p=0.006)。将弓形虫特异性抗生素治疗后的无复发中位生存时间与不进行治疗的情况相比较时,未发现差异(p=0.679)。
尽管我们的研究表明药物治疗似乎会影响OT的复发风险,但在德国海德堡大学跨学科葡萄膜炎中心的服务区域,对于治疗方案中抗寄生虫药物的选择尚无共识。调查结果为治疗医生和对治疗感兴趣的临床研究人员提供了有用信息。