Skip to main content
Top
Published in: International Ophthalmology 6/2018

01-12-2018 | Original Paper

Assessment of ocular toxoplasmosis patients reported at a tertiary center in the northeast of Iran

Authors: Seyedeh Maryam Hosseini, Elham Moghaddas, Karim Sharifi, Malihe Dadgar Moghaddam, Seyed Aliakbar Shamsian

Published in: International Ophthalmology | Issue 6/2018

Login to get access

Abstract

Purpose

Ocular toxoplasmosis, which is caused by the single-cell parasite Toxoplasma gondii, is currently the most significant cause of posterior uveitis in the world. No previous studies have described the prevalence and clinical features of ocular toxoplasmosis in the northeast of Iran. The purpose of the current study was to address this gap.

Methods

In this retrospective study, the medical records of 488 uveitis patients who presented to the Khatam-al-Anbia Eye Hospital of Mashhad University of Medical Sciences, a tertiary ophthalmology center in the northeast of Iran, between January 2013 and December 2015 were evaluated. The clinical features and risk factors of 99 (20%) consecutive patients with ocular toxoplasmosis were extracted.

Results

Ninety-nine including 53 (53.5%) female and 46 (46.5%) male patients with ocular toxoplasmosis were included in the analysis. Reduced vision (77%) and floaters (15.2%) were the most common presenting symptoms. The age category that was most affected by ocular toxoplasmosis was 20–40 years (range: 11–65 years) with a mean age of 27.2. All patients had retinochoroiditis, but just two had anterior uveitis. All of the extracted patients, with the exception of three patients, had unilateral involvement. None of the patients had any other medical disorders with the exception of one woman, who had diabetes. Only four recurring ocular toxoplasmosis patients were referred to the education hospital during the study. Serology data were available for just 32 patients, of which 31 (96.8%) were IgG positive, and 1 (3.2%) was IgM positive.

Conclusion

Toxoplasma gondii was responsible for 20% of the patients of uveitis that presented to the largest ophthalmology center in the northeast of Iran. There is a high incidence of patients of ocular toxoplasmosis in the northeast of Iran, and it is a significant cause of uveitis and visual impairment in this area.
Literature
1.
go back to reference Päivönsalo-Hietanen T, Tuominen J, Vaahtoranta-Lehtonen H, Saari KM (1997) Incidence and prevalence of different uveitis entities in Finland. Acta Ophthalmol 75(1):76–81CrossRef Päivönsalo-Hietanen T, Tuominen J, Vaahtoranta-Lehtonen H, Saari KM (1997) Incidence and prevalence of different uveitis entities in Finland. Acta Ophthalmol 75(1):76–81CrossRef
2.
go back to reference Holland GN (2003) Ocular toxoplasmosis: a global reassessment: part I: epidemiology and course of disease. Am J Ophthalmol 136(6):973–988CrossRef Holland GN (2003) Ocular toxoplasmosis: a global reassessment: part I: epidemiology and course of disease. Am J Ophthalmol 136(6):973–988CrossRef
3.
go back to reference Ferreira A, Frederico F, Meira C, Almeida G, Nakashima F, Bernardo C, Pereira-Chioccola V, De Mattos L (2014) Risk factors for ocular toxoplasmosis in Brazil. Epidemiol Infect 142(01):142–148PubMed Ferreira A, Frederico F, Meira C, Almeida G, Nakashima F, Bernardo C, Pereira-Chioccola V, De Mattos L (2014) Risk factors for ocular toxoplasmosis in Brazil. Epidemiol Infect 142(01):142–148PubMed
4.
go back to reference Park YH, Nam HW (2013) Clinical features and treatment of ocular toxoplasmosis. Korean J Parasitol 51(4):393CrossRef Park YH, Nam HW (2013) Clinical features and treatment of ocular toxoplasmosis. Korean J Parasitol 51(4):393CrossRef
5.
go back to reference Holland GN (2009) Ocular toxoplasmosis: the influence of patient age. Mem Inst Oswaldo Cruz 104(2):351–357CrossRef Holland GN (2009) Ocular toxoplasmosis: the influence of patient age. Mem Inst Oswaldo Cruz 104(2):351–357CrossRef
6.
go back to reference Gilbert RE, Stanford MR (2000) Is ocular toxoplasmosis caused by prenatal or postnatal infection? Br J Ophthalmol 84(2):224–226CrossRef Gilbert RE, Stanford MR (2000) Is ocular toxoplasmosis caused by prenatal or postnatal infection? Br J Ophthalmol 84(2):224–226CrossRef
7.
go back to reference Rothova A (1993) Ocular involvement in toxoplasmosis. Br J Ophthalmol 77(6):371CrossRef Rothova A (1993) Ocular involvement in toxoplasmosis. Br J Ophthalmol 77(6):371CrossRef
8.
go back to reference Couvreur J, Thulliez P (1996) Acquired toxoplasmosis of ocular or neurologic site: 49 cases. Presse Med 25(9):438–442PubMed Couvreur J, Thulliez P (1996) Acquired toxoplasmosis of ocular or neurologic site: 49 cases. Presse Med 25(9):438–442PubMed
9.
go back to reference Leblanc A, Bamberger J, Guillien F, Benoit A, Baufine-Ducroq H, Quillet P (1985) Acquired toxoplasmic chorioretinitis with a late onset. Arch Fr Pediatr 42(1):37–39PubMed Leblanc A, Bamberger J, Guillien F, Benoit A, Baufine-Ducroq H, Quillet P (1985) Acquired toxoplasmic chorioretinitis with a late onset. Arch Fr Pediatr 42(1):37–39PubMed
10.
go back to reference Holland GN, O’Connor GR, Junior Belfort R, Remington JS (1996) Toxoplasmosis. In: Pepose JS, Holland GN, Wilhelmus KR (eds) Ocular infection and immunity. Mosby, St. Louis, pp 1183–1223 Holland GN, O’Connor GR, Junior Belfort R, Remington JS (1996) Toxoplasmosis. In: Pepose JS, Holland GN, Wilhelmus KR (eds) Ocular infection and immunity. Mosby, St. Louis, pp 1183–1223
11.
go back to reference Holland GN, Buhles WC, Mastre B, Kaplan HJ (1989) A controlled retrospective study of ganciclovir treatment for cytomegalovirus retinopathy: use of a standardized system for the assessment of disease outcome. Arch Ophthalmol 107(12):1759–1766CrossRef Holland GN, Buhles WC, Mastre B, Kaplan HJ (1989) A controlled retrospective study of ganciclovir treatment for cytomegalovirus retinopathy: use of a standardized system for the assessment of disease outcome. Arch Ophthalmol 107(12):1759–1766CrossRef
12.
go back to reference Kianersi F, Mohammadi Z, Ghanbari H, Ghoreyshi SM, Karimzadeh H, Soheilian M (2015) Clinical patterns of uveitis in an Iranian tertiary eye-care center. Ocul Immunol Inflamm 23(4):278–282CrossRef Kianersi F, Mohammadi Z, Ghanbari H, Ghoreyshi SM, Karimzadeh H, Soheilian M (2015) Clinical patterns of uveitis in an Iranian tertiary eye-care center. Ocul Immunol Inflamm 23(4):278–282CrossRef
13.
go back to reference Fallah E, Mahami L, Javadzadeh A, Mahami M, Hamzavi F, Monajjem H (2013). Study of 191 patients eye toxoplasmosis referring to hospital Tabriz—Iran. In: The 6th international and 11th national congress on quality improvement in clinical laboratory, Tehran, Iran Fallah E, Mahami L, Javadzadeh A, Mahami M, Hamzavi F, Monajjem H (2013). Study of 191 patients eye toxoplasmosis referring to hospital Tabriz—Iran. In: The 6th international and 11th national congress on quality improvement in clinical laboratory, Tehran, Iran
14.
go back to reference Pathanapitoon K, Kunavisarut P, Ausayakhun S, Sirirungsi W, Rothova A (2008) Uveitis in a tertiary ophthalmology centre in Thailand. Br J Ophthalmol 92(4):474–478CrossRef Pathanapitoon K, Kunavisarut P, Ausayakhun S, Sirirungsi W, Rothova A (2008) Uveitis in a tertiary ophthalmology centre in Thailand. Br J Ophthalmol 92(4):474–478CrossRef
15.
go back to reference Wang L, L-y He, Z-w Chen, Wen H, G-s Fang, Q-l Luo, K-q Huang, J-l Shen (2015) Seroprevalence and genetic characterization of Toxoplasma gondii in cancer patients in Anhui Province, Eastern China. Parasit Vectors 8(1):1CrossRef Wang L, L-y He, Z-w Chen, Wen H, G-s Fang, Q-l Luo, K-q Huang, J-l Shen (2015) Seroprevalence and genetic characterization of Toxoplasma gondii in cancer patients in Anhui Province, Eastern China. Parasit Vectors 8(1):1CrossRef
16.
go back to reference Balasundaram MB, Andavar R, Palaniswamy M, Venkatapathy N (2010) Outbreak of acquired ocular toxoplasmosis involving 248 patients. Arch Ophthalmol 128(1):28–32CrossRef Balasundaram MB, Andavar R, Palaniswamy M, Venkatapathy N (2010) Outbreak of acquired ocular toxoplasmosis involving 248 patients. Arch Ophthalmol 128(1):28–32CrossRef
17.
go back to reference Petersen E, Kijlstra A, Stanford M (2012) Epidemiology of ocular toxoplasmosis. Ocul Immunol Inflamm 20(2):68–75CrossRef Petersen E, Kijlstra A, Stanford M (2012) Epidemiology of ocular toxoplasmosis. Ocul Immunol Inflamm 20(2):68–75CrossRef
18.
go back to reference Kovačević-Pavićević D, Radosavljević A, Ilić A, Kovačević I, Djurković-Djaković O (2012) Clinical pattern of ocular toxoplasmosis treated in a referral centre in Serbia. Eye 26(5):723–728CrossRef Kovačević-Pavićević D, Radosavljević A, Ilić A, Kovačević I, Djurković-Djaković O (2012) Clinical pattern of ocular toxoplasmosis treated in a referral centre in Serbia. Eye 26(5):723–728CrossRef
19.
go back to reference Garweg JG, Scherrer JN, Halberstadt M (2008) Recurrence characteristics in European patients with ocular toxoplasmosis. Br J Ophthalmol 92(9):1253–1256CrossRef Garweg JG, Scherrer JN, Halberstadt M (2008) Recurrence characteristics in European patients with ocular toxoplasmosis. Br J Ophthalmol 92(9):1253–1256CrossRef
20.
go back to reference Tabatabaei S, Soleimani M, Foroutan A, Ahmadabadi M, Zarei R, Piri N, Gordiz A (2011) Ocular toxoplasmosis in Iran: 40 cases analysis. Int J Ophthalmol 4(2):199PubMedPubMedCentral Tabatabaei S, Soleimani M, Foroutan A, Ahmadabadi M, Zarei R, Piri N, Gordiz A (2011) Ocular toxoplasmosis in Iran: 40 cases analysis. Int J Ophthalmol 4(2):199PubMedPubMedCentral
21.
go back to reference Aleixo A, Benchimol EI, Neves EdS, Silva CSP, Coura LC, Amendoeira MRR (2009) Frequency of lesions suggestive of ocular toxoplasmosis among a rural population in the State of Rio de Janeiro. Rev Soc Bras Med Trop 42(2):165–169CrossRef Aleixo A, Benchimol EI, Neves EdS, Silva CSP, Coura LC, Amendoeira MRR (2009) Frequency of lesions suggestive of ocular toxoplasmosis among a rural population in the State of Rio de Janeiro. Rev Soc Bras Med Trop 42(2):165–169CrossRef
22.
go back to reference Jones JL, Muccioli C, Belfort R Jr, Holland GN, Roberts JM, Silveira C (2006) Recently acquired Toxoplasma gondii infection, Brazil. Emerg Infect Dis 12(4):582–587CrossRef Jones JL, Muccioli C, Belfort R Jr, Holland GN, Roberts JM, Silveira C (2006) Recently acquired Toxoplasma gondii infection, Brazil. Emerg Infect Dis 12(4):582–587CrossRef
23.
go back to reference Bosch-Driessen LE, Berendschot TT, Ongkosuwito JV, Rothova A (2002) Ocular toxoplasmosis: clinical features and prognosis of 154 patients. Ophthalmol 109(5):869–878CrossRef Bosch-Driessen LE, Berendschot TT, Ongkosuwito JV, Rothova A (2002) Ocular toxoplasmosis: clinical features and prognosis of 154 patients. Ophthalmol 109(5):869–878CrossRef
24.
go back to reference Chapman D, Ashburn D, Ogston S, Ho D (1999) The relationship between ocular toxoplasmosis and levels of specific toxoplasma antibodies. Epidemiol Infect 122(2):299–303CrossRef Chapman D, Ashburn D, Ogston S, Ho D (1999) The relationship between ocular toxoplasmosis and levels of specific toxoplasma antibodies. Epidemiol Infect 122(2):299–303CrossRef
25.
go back to reference Dodds EM, Holland GN, Stanford MR, Yu F, Siu WO, Shah KH, ten Dam-van Loon N, Muccioli C, Hovakimyan A, Barisani-Asenbauer T (2008) Intraocular inflammation associated with ocular toxoplasmosis: relationships at initial examination. Am J Ophthalmol 146(6):856–865CrossRef Dodds EM, Holland GN, Stanford MR, Yu F, Siu WO, Shah KH, ten Dam-van Loon N, Muccioli C, Hovakimyan A, Barisani-Asenbauer T (2008) Intraocular inflammation associated with ocular toxoplasmosis: relationships at initial examination. Am J Ophthalmol 146(6):856–865CrossRef
26.
go back to reference Sheth DS, Kulkarni P, Natarajan S (2016) A case series of retinochoroidal toxoplasmosis from Western India: guide to salient features, diagnosis and treatment. J Appl Biosci 3(1):A5–A11 Sheth DS, Kulkarni P, Natarajan S (2016) A case series of retinochoroidal toxoplasmosis from Western India: guide to salient features, diagnosis and treatment. J Appl Biosci 3(1):A5–A11
27.
go back to reference Utomo PT, Agni AN (2003) Clinical manifestations of ocular toxoplasmosis in Yogyakarta, Indonesia: a clinical review of 173 cases. Southeast Asian J Trop Med Public Health 34(2):291–297PubMed Utomo PT, Agni AN (2003) Clinical manifestations of ocular toxoplasmosis in Yogyakarta, Indonesia: a clinical review of 173 cases. Southeast Asian J Trop Med Public Health 34(2):291–297PubMed
28.
go back to reference Montoya JG (2002) Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis. J Infect Dis 185:S73–S82CrossRef Montoya JG (2002) Laboratory diagnosis of Toxoplasma gondii infection and toxoplasmosis. J Infect Dis 185:S73–S82CrossRef
Metadata
Title
Assessment of ocular toxoplasmosis patients reported at a tertiary center in the northeast of Iran
Authors
Seyedeh Maryam Hosseini
Elham Moghaddas
Karim Sharifi
Malihe Dadgar Moghaddam
Seyed Aliakbar Shamsian
Publication date
01-12-2018
Publisher
Springer Netherlands
Published in
International Ophthalmology / Issue 6/2018
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-017-0764-3

Other articles of this Issue 6/2018

International Ophthalmology 6/2018 Go to the issue