Respective Roles of Acquired and Congenital Infections in Presumed Ocular Toxoplasmosis

Purpose

To analyze the roles of acquired or congenital infections in cases of ocular toxoplasmosis, and to compare their clinical manifestations.

Design

Retrospective, observational case series.

Methods

We analyzed the charts of consecutive patients with a diagnosis of ocular toxoplasmosis. Data from the French program for the prevention of congenital toxoplasmosis were used to assess the origin of infection. The data included patients' serologic status prior to their ocular manifestations and patients' mothers' serologic status before, during, and/or after pregnancy. Infections were categorized as congenital, acquired, or unknown.

Results

Of 425 cases of ocular toxoplasmosis, 100 (23.5%) were acquired, 62 (14.6%) were congenital, and 263 (61.9%) were of unknown origin. At the time of the study, the mean age of the patients with congenital ocular toxoplasmosis was 9.1 ± 8.8 years, and was 21.7 ± 12.6 years in the patients with acquired ocular toxoplasmosis (P < .0001). Bilateral chorioretinitis was observed in 4% of acquired cases and in 43.5% of congenital cases (P < .0001). In acquired infections, mean decimal visual acuity (VA) was 1.0 (logarithm of the minimum angle of resolution [logMAR] 0.0 ± 1 line) in the best eye and 0.4 (logMAR 0.4 ± 5 lines) in the worst eye. In congenital cases, mean decimal VA was 0.8 (logMAR 0.1 ± 4 lines) in the best eye and 0.25 (logMAR 0.6 ± 7 lines) in the worst eye (P < .05).

Conclusion

In cases where the origin of the infection could be determined, acquired infections were a more frequent cause of ocular toxoplasmosis than congenital infections. Cases of congenital ocular toxoplasmosis were more severe than acquired cases.