Miyagaki Miki, Zong Yuan, Yang Mingming, Zhang Jing, Zou Yaru, Ohno-Matsui Kyoko, Kamoi Koju
Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
Pathogens. 2024 Oct 14;13(10):898. doi: 10.3390/pathogens13100898.
, an obligate intracellular parasite, is a globally prevalent pathogen capable of infecting a wide range of warm-blooded animals, including humans. Ocular toxoplasmosis (OT), a severe manifestation of infection, can lead to potentially blinding complications. This comprehensive review delves into the current understanding of biology, exploring its complex life cycle, diverse transmission routes, and strain diversity. This article provides an in-depth analysis of the clinical manifestations of OT, which can result from both congenital and acquired infections, presenting a spectrum of signs and symptoms. The review examines various diagnostic strategies employed for OT, including clinical examination, multimodal imaging techniques such as fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA), as well as laboratory tests including serology and molecular methods. Despite extensive research, the specific mechanisms underlying ocular involvement in infection remain elusive, and current diagnostic options have limitations. Moreover, the treatment of active and recurrent OT remains a challenge. While existing therapies, such as antimicrobial agents and immunosuppressants, can control active infections, they do not offer a definitive cure or completely prevent recurrence. The clinical endpoints for the management of active and recurrent OT are also not yet well-established, and the available treatment methods carry the potential for adverse effects. This article highlights the need for future research to elucidate the pathogenesis of OT, investigate genetic factors influencing susceptibility to infection, and develop more sensitive and specific diagnostic tools. Enhancing global surveillance, implementing robust prevention strategies, and fostering multidisciplinary collaborations will be crucial in reducing the burden of OT and improving patient outcomes. This comprehensive review aims to provide a valuable resource for clinicians, researchers, and policymakers, contributing to a better understanding of infection and its impact on ocular health.
作为一种专性细胞内寄生虫，是一种全球普遍存在的病原体，能够感染包括人类在内的多种温血动物。眼部弓形虫病（OT）是感染的一种严重表现，可导致潜在的致盲并发症。这篇综述深入探讨了目前对其生物学的认识，探索了其复杂的生命周期、多样的传播途径和菌株多样性。本文深入分析了OT的临床表现，其可由先天性和获得性感染引起，呈现出一系列体征和症状。该综述研究了用于OT的各种诊断策略，包括临床检查、多模态成像技术，如眼底荧光血管造影（FFA）、吲哚菁绿血管造影（ICGA）、光学相干断层扫描（OCT）和光学相干断层扫描血管造影（OCTA），以及实验室检查，包括血清学和分子方法。尽管进行了广泛的研究，但感染累及眼部的具体机制仍不清楚，目前的诊断方法也存在局限性。此外，活动性和复发性OT的治疗仍然是一项挑战。虽然现有疗法，如抗菌药物和免疫抑制剂，可以控制活动性感染，但它们并不能提供根治方法或完全预防复发。活动性和复发性OT管理的临床终点也尚未明确确立，现有治疗方法存在潜在的不良反应。本文强调了未来研究的必要性，以阐明OT的发病机制，研究影响感染易感性的遗传因素，并开发更敏感和特异的诊断工具。加强全球监测、实施强有力的预防策略以及促进多学科合作对于减轻OT负担和改善患者预后至关重要。这篇综述旨在为临床医生、研究人员和政策制定者提供有价值的资源，有助于更好地理解感染及其对眼部健康的影响。
