Ocular toxoplasmosis can be a progressive and recurring disease that can threaten visual function. Retinochoroiditis develops gradually weeks to years after subclinical
congenital toxoplasmosis; this is the preponderant form, which is frequently bilateral; with healing, white or dark-pigmented
scars may result.
Toxoplasmosis acquired in older children and adults rarely progresses to retinochoroiditis; it is generally unilateral. We report the results of a clinical study concerning 16 patients with
ocular toxoplasmosis observed for the first time in the period from 1992 to 2004 and followed up until today. The patients came to the Department of
Infectious Diseases of the Second University of Naples. We studied 16 patients, 10 of whom were females; 11 cases presented ocular signs of
congenital toxoplasmosis, while in 5 cases ocular impairment was related to an acquired
toxoplasmosis. Only one case of congenital toxoplasma
chorioretinitis was symptomatic at birth: it was complicated by
microphthalmia and
strabismus, calcifications in the brain and
epilepsy; 10 congenital cases were asymptomatic at birth and were recognized after several years because of a reactivation of
infection. In 5 patients congenital
chorioretinitis was bilateral, with presence of
scars in the contralateral eye. The 5 cases of acquired toxoplasma
retinitis were ascertained by anamnestic, serologic and ophthalmologic examinations; in 4 of them the lesion was typical and unilateral; the 5th case was a 6-year-old boy with acquired toxoplasma bilateral
neuroretinitis. 13/16 cases of
ocular toxoplasmosis were treated with the combination of
pyrimethamine,
sulfadiazine; they were followed up and re-treated if necessary. The
therapy was curative in each case. Our experience confirms that late-onset
retinal lesions and relapse can occur many years after birth but that the overall ocular prognosis is satisfactory when congenital damage is recognized early and treated appropriately. Prevention of congenital and acquired
toxoplasmosis is very important in controlling
ocular toxoplasmosis.