Ocular toxoplamoi: a global reaement : part II: dieae manifetation and management

Purpoe To update clinical information about ocular toxoplamoi. Part II review the pectrum of dieae manifetation and factor that influence everity of dieae. Implication for dieae management are dicued. Deign Literature review. Method elected article from the medical literature, information from everal recent cientific meeting, and the authorʹ peronal experience were reviewed critically in preparation for the LX Edward Jackon Memorial Lecture. Reult The appearance of toxoplamic retinochoroiditi leion varie with duration of active retinal infection and intenity of inflammation. evere ocular dieae occur in immunocompromied hot. Older patient who are recently infected with Toxoplama gondii may have a higher prevalence of ocular involvement and more evere ocular dieae becaue of altered hot defene. Mot dieae-producing iolate of T. gondii belong to one of three clonal lineage (type I, II, III); type I ha been aociated with evere dieae in both animal and human being. Many obervational tudie ugget a benefit of hort-term antimicrobial therapy for toxoplamic retinochoroiditi in immunocompetent patient, although the efficacy of thee treatment ha not been proven in randomized clinical trial. Intermittent trimethoprim/ulfamethoxazole treatment wa aociated with fewer recurrence than placebo during a 20-month randomized clinical trial. Concluion Variation in dieae characteritic may be related to hot, paraite, or environmental factor. The genotype of the infecting paraite appear to be an important determinant of dieae everity in immunocompetent patient. econdary prophylaxi may reduce the rate of recurrence in high-rik patient. A better clinical undertanding of ocular toxoplamoi can lead to more effective prevention and treatment trategie