Faculty Collaboration Database

Visual Outcomes in Presumed Congenital Foveal Toxoplasmosis. Am J Ophthalmol 2020 Jun;214:9-13

Date

02/10/2020

Pubmed ID

32035830

DOI

10.1016/j.ajo.2020.01.034

Scopus ID

2-s2.0-85082666165 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

PURPOSE: Congenital macular lesions attributed to toxoplasmosis may limit potential visual acuity. The appearance and location of these scars may cause physicians to overlook associated amblyopia. This study reviews the visual outcomes and benefits of amblyopia therapy in children with foveal toxoplasmosis scars.

DESIGN: Retrospective observational case series.

METHODS: Setting: Single center.

PATIENT POPULATION: Children with presumed foveal toxoplasmosis scars who underwent amblyopia treatment.

MAIN OUTCOME MEASURE: Charts were reviewed for amblyopia treatment, fundus photographs, optical coherence tomography (OCT), and visual acuity.

RESULTS: Median age at presentation was 2.8 years and median follow-up was 6.2 years. Occlusion therapy was undertaken in 9 patients. Median duration of occlusion therapy was 1.7 years. Six patients improved with occlusion therapy (average 4.6 lines gained on optotype acuity). Final visual acuity ranged from 20/25 to 20/250, with 6 of 8 patients better than 20/80. OCT confirmed macular scars in 5 patients, with varying degrees of foveal architecture disruption.

CONCLUSION: Despite the striking appearance of the lesions in patients with presumed foveal toxoplasmosis, visual potential may be better than expected. The appearance of the lesions is not always predictive of visual outcome. A trial of occlusion therapy to treat amblyopia should be initiated in these patients to ensure that they reach their maximal visual potential.

Author List

Reynolds MMM, Chisholm SAM, Schroeder R, Lueder GT

Author

Smith Ann Meile Chisholm MD Assistant Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Amblyopia
Atropine
Child
Child, Preschool
Female
Follow-Up Studies
Fovea Centralis
Humans
Infant
Male
Mydriatics
Retinal Diseases
Retrospective Studies
Sensory Deprivation
Tomography, Optical Coherence
Toxoplasmosis, Congenital
Toxoplasmosis, Ocular
Visual Acuity