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当前眼弓形体病的治疗实践:巴西葡萄膜炎专家调查。

Current Practices in Ocular Toxoplasmosis: A Survey of Brazilian Uveitis Specialists.

机构信息

a Universidade Federal de São Paulo - UNIFESP , Department of Ophthalmology , São Paulo , São Paulo , Brazil.

b Fundação Altino Ventura , Recife , Pernambuco , Brazil.

出版信息

Ocul Immunol Inflamm. 2018;26(2):317-323. doi: 10.1080/09273948.2016.1215471. Epub 2016 Sep 6.

Abstract

PURPOSE

To describe treatment practices for ocular toxoplasmosis among members of the Brazilian Uveitis Society.

METHODS

An online questionnaire sent to specialists, between October 2014 and March 2015.

RESULTS

Most respondents (67.9%) treat all active cases. Most specialists consider visual acuity <20/200 (88.2%), severe vitreous inflammation (94.1%), and ocular disease during acquired infection (88.2%) as absolute indications for treatment. Systemic steroids are associated with anti-toxoplasmic therapy in most cases by 50.9% of the respondents. For immunocompetent individuals, 57.4% of the respondents chose trimethoprim/sulfamethoxazole. Classical therapy (sulfadiazine/pyrimethamine) is preferred most for patients with central lesions (70.4%), immunosuppression (68.4%), acquired infection (70.4%), and atypical forms (74.1%). For patients with frequent relapses, 84.9% of the respondents preferred antibiotic prophylaxis.

CONCLUSIONS

Treatment patterns of ocular toxoplasmosis are not uniform among Brazilian specialists. Most specialists treat all cases of active retinochoroiditis. Typical cases are more frequently treated with trimethoprim/sulfamethoxazole. However, classical therapy is the regimen of choice when lesions are considered more severe.

摘要

目的

描述巴西葡萄膜炎学会成员对眼弓形体病的治疗实践。

方法

2014 年 10 月至 2015 年 3 月,向专家发送在线问卷。

结果

大多数(67.9%)受访者治疗所有活动性病例。大多数专家认为视力<20/200(88.2%)、严重玻璃体炎症(94.1%)和获得性感染时的眼部疾病(88.2%)是治疗的绝对指征。50.9%的受访者认为全身皮质类固醇与抗弓形体治疗相关。对于免疫功能正常的个体,57.4%的受访者选择复方磺胺甲噁唑。经典疗法(磺胺嘧啶/乙胺嘧啶)最常用于中央病变(70.4%)、免疫抑制(68.4%)、获得性感染(70.4%)和非典型病例(74.1%)。对于频繁复发的患者,84.9%的受访者首选抗生素预防。

结论

巴西专家对眼弓形体病的治疗模式并不统一。大多数专家治疗所有活动性视网膜炎病例。典型病例更常使用复方磺胺甲噁唑治疗。然而,当病变被认为更严重时,经典疗法是首选方案。

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