Simsek Mert, Ozdal Pinar Cakar, Kocer Ali Mert
Department of Ophthalmology, Sorgun State Hospital, Yozgat, Turkey.
Department of Ophthalmology, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey.
Arq Bras Oftalmol. 2019 Jul-Aug;82(4):302-309. doi: 10.5935/0004-2749.20190058. Epub 2019 Apr 8.
To evaluate the prevalence, clinical characteristics, and types of optic nerve involvement in patients with ocular toxoplasmosis.
For this retrospective cross-sectional study, we examined all patients with active ocular toxoplasmosis referred to our Uveitis Section during the last 12 years, and we included patients with optic nerve involvement in the study. The primary outcome was the prevalence of optic nerve involvement, and secondary outcomes included the types of optic nerve involvement and the final best-corrected visual acuity after treatment.
The prevalence of optic nerve involvement was 14.4%, with the leading cause being the activation of a juxtapapillary lesion (70.5%). We found papillitis in two eyes and neuroretinitis in two eyes (11.7% for each). We only detected one optic nerve involvement secondary to a distant active lesion (5.8%). Sixteen patients (94.1%) had unilateral ocular toxoplasmosis. The overall final best-corrected visual acuity after treatment was 10/10 (LogMAR = 0.0) excluding the three patients with a juxtapapillary scar involving the macula.
Optic nerve involvement was common in patients with ocular toxoplasmosis. The main type of optic nerve involvement was caused by activation of an old juxtapapillary lesion. Treatment was quickly effective, but the best-corrected visual acuity was dependent on the presence of a scar in the papillomacular bundle.
评估眼部弓形虫病患者视神经受累的患病率、临床特征及类型。
在这项回顾性横断面研究中，我们检查了过去12年转诊至我们葡萄膜炎科的所有活动性眼部弓形虫病患者，并将视神经受累患者纳入研究。主要结局是视神经受累的患病率，次要结局包括视神经受累类型及治疗后的最终最佳矫正视力。
视神经受累的患病率为14.4%，主要原因是视乳头旁病变的激活（70.5%）。我们发现2只眼有视乳头炎，2只眼有视神经视网膜炎（各占11.7%）。我们仅检测到1例继发于远处活动性病变的视神经受累（5.8%）。16例患者（94.1%）患有单侧眼部弓形虫病。排除3例视乳头黄斑束有瘢痕累及黄斑的患者后，治疗后的总体最终最佳矫正视力为10/10（LogMAR = 0.0）。
视神经受累在眼部弓形虫病患者中很常见。视神经受累的主要类型是由陈旧性视乳头旁病变的激活引起的。治疗迅速有效，但最佳矫正视力取决于视乳头黄斑束是否存在瘢痕。
