Eye Manifestations

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Eighty-five percent of patients with subclinical congenital infections are reported to develop chorioretinitis [70]. The eye manifestations of congenital toxoplasmosis found in a large study are summarized in Table 13.1 [48].

Anterior Segment. Microcornea was seen in 19% of patients and cataracts in 10% [49]. It should be noted that these were never isolated findings and that they were always seen in association with posterior segment disease.

Retina. The most common eye finding in patients with congenital toxoplasmosis is chori-oretinal scars, which were present in 79 % of the patients. The classic location is the macula (Fig. 13.1); however, the most common location was in the periphery (64%). If you consider the total surface area of the retina, there was a predisposition for the macular area (58%). In addition, active retinitis was seen in 11 % and retinal detachment in 10% [49].

Optic Nerve. Optic atrophy was present in 20 % of patients with congenital toxoplasmosis [49].

Microphthalmia and Phthisis. Microphthalmia and phthisis were reported in 13% and 4%, respectively [49].

Visual acuity ranges from 20/20 to 20/400 in the presence of macular lesions, the better vision being unexpected [49]. Therefore, pre-

Table13.1. Ophthalmology manifestations of congenital toxoplasmosis

Diagnoses of patients checked

Percentage of patients with findings

Chorioretinal scars

79 (74)

Macular

58 (52/89)

Juxtapapillary

52 (46/89)

Peripheral

64 (57/89)

Strabismus

33 (31)

Nystagmus

27 (25)

Optic atrophy

20 (19)

Microcornea

19 (18)

Microphthalmos

13 (12)

Retinitis (active)

11 (10)

Cataract

10 (9)

Retinal detachment

10 (9)

Vitreitis (active)

5 (5)

Phthisis

4 (4)

Numerator represents number of patients with finding; denominator is the total number, unless otherwise specified. Patients with bilateral retinal detachment in whom the location of scars was not possible were excluded from the denominator. Number in parentheses is total number of patients with findings

Numerator represents number of patients with finding; denominator is the total number, unless otherwise specified. Patients with bilateral retinal detachment in whom the location of scars was not possible were excluded from the denominator. Number in parentheses is total number of patients with findings

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