Ophtalmologic, Serologic and Therapeutic Aspects of Ocular Toxoplasmosis Toxoplasmose Oculaire: Aspects Ophtalmologiques, Sérologiques et Thérapeutiques

Abstract

Ocular toxoplasmosis (OT) is the most frequent cause of inflammation of the posterior segment of the eye due to infectious causes. It can occur in congenital toxoplasmosis, in the immunocom promised and, more rarely, in the immuno competent. It is a critical disease, as it can lead to blindness. The aim of our study was to investigate the clinical, serological, and therapeutic features of TO. Methods: A bicentric retrospective study was conducted at the Parasitology-Mycology laboratories of two Tunisian Hospitals(2017-2021), involving toxoplasma serologies performed on 175 patients in the context of exploration for uveitis and on six babies with congenital toxoplasmosis. As screening technique, we used was electrochemilum inescence (Cobas® e411) and Enzyme Linked Filtration Assay (mini-Vidas®). If IgM and/or IgG were positive, and depending on ophthalmo logical signs, we added a comparative Western Blot (WB) of serum and aqueous humor. Results Serological results were: – no immunity in 71 patients, rejecting OT – long-standing immunity in 103 patients, 15 of whom underwent comparative WB tests, four of which were positive- recent primary infection in one case with a positive WB. Thus, five cases of OT were confirmed(Three panuveitis and two anterior uveitis). Their respective ages were 14, 25, 33, 43 and 50 years old.Ophthalmological follow-up of five babies during the first year of life (one lost at six months) revealed chorioretinitis in one baby only. Conclusion Ocular involvement may represent a late revelation of unrecognized congenital toxoplasmosis. Its occurrence in immuno competent is not exceptional, but remains underestimated, as aqueous humor puncture is not systematically performed due to its invasive nature.