Ocular lesion due to congenital infections (Cytomegalovirus, Toxoplasmosis), diagnosis, treatment and followup: A prospective study in Tehran, Iran

Abstract

Background: Intrauterine infections lead to involvement of various organs in fetus, including the eye. The aim of this study was to determine the frequency and clinical response of ocular lesions to specific drugs in infants with congenital Toxoplasma and cytomegalovirus infections. Methods: This historical cohort study was performed in the pediatric and ophthalmology department of Hazrat Rasool Akram Hospital in Tehran from October 2011 to November 2017. Patients included 78 infants with intrauterine infection (proven) and ocular involvement (cataracts, glaucoma, and retinitis). Infants who did not undergo additional and diagnostic tests, eye examinations, follow-up and did not receive effective treatment were excluded from the study. Three patients expired during the study. Finally, 37 patients (including 25 patients with cytomegalovirus and 12 patients with toxoplasma) were included to assess and the clinical response to ocular lesions was evaluated for one year Results: Of 12 cases with toxoplasmosis, 5 patients received complete treatment and 4 patients had appropriate clinical responses. Of 25 patients with CMV, 18 patients received complete treatment and 9 patients had appropriate clinical responses. Conclusion: Successful treatment will be obtained in near 80% of ocular toxoplasmosis, so anti toxoplasma treatment is recommended in all confirmed cases. About 50% of CMV infected cases (with hearing loss, ocular involvement) might respond well to antiviral therapy, We recommend anti CMV treatment in any age ( <2 years old) but it is not indicated in CMV infected cases with severe brain involvement.