Recurrence of toxoplasmic retinochoroiditis: Analysis of cases proven by initial analysis of aqueous humor

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Abstract

Purpose

Factors explaining recurrences of toxoplasmic retinochoroiditis (TRC) and their frequency are not understood. The aim of this study is to analyze their recurrence patterns, and search for an association with their clinical and biological features.

Methods

40 consecutive cases of TRC with a positive aqueous humour (AH) tap for toxoplasmosis were retrospectively included. Inclusion criteria were: Goldman-Witmer coefficient (GWC)>2.0, positive immunoblot (IB) or positive PCR for Toxoplasma gondii. Further episodes, their characteristics, disease-free intervals, and treatments were collected. We performed a case-control analysis of patients with and without recurrences during follow-up.

Results

Mean age was 41.5 years. 10% of patients were immunodeficient (n=4). Mean follow-up was 7.3 years (5.8-10.3). Forty-three percent of patients (n=17) presented at least one recurrence, with a mean of 1.7 episodes (1-4) per patient. Mean interval between episodes was 27 months (3-73). For patients experiencing one recurrence or more, initial AH analysis showed a lower GWC, less additional bands on IB, and less positive PCRs, even though these trends did not reach statistical significance. Clinically, these patients had broader lesions, in more peripheral locations, and more intense vitritis than those with no recurrences. For the initial episode, durations of antibiotic and anti-inflammatory treatments were superior in the recurrence group. Sex, ethnicity, or immune status were not associated with a change in recurrence risk.

Conclusion

TRC recurrences seem to be influenced by clinical and biological features at baseline.

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