Patients who test positive for congenital ocular toxoplasmosis require early treatment, preferably within the first 4 (and better yet, within the first 2) months of life, due to their high incidence of developing retinochoroidal lesions, according to a retrospective cohort study published in The Pediatric Infectious Disease Journal. The research added that their ocular health requires long-term follow-up. In the Brazillian population in which this study was conducted, these patients had a high morbidity rate.
The study examined patient records of Hospital São Lucas at Pontifical Catholic University of Rio Grande do Sul, in Porto Alegre in southern Brazil, from 1996 to 2017. The inclusion criteria were follow-up for at least 12 months with persistence of anti-Toxoplasma gondii immunoglobulin G during follow-up. Patients with congenital toxoplasmosis had received drug therapies such as pyrimethamine and folinic acid as well as corticosteroids and neurosurgical procedures within the first year of life.
Of the included records, researchers identified 65 via routine screening. The median age of patients at follow-up was 10 years. During follow-up, 55 patients presented with retinochoroiditis. Investigators discovered that retinochoroidal lesions were present during the first year of life in 77.8% of patients who began treatment between the 5th and 10th months of life but in only 33.3% of patients treated within the first 2 months of life (P =.01). Incidences of new retinochoroidal lesions seemed to peak between ages 4 and 5 years, and again between ages 9 and 11 years, with the later peak only happening among female patients. Researchers followed 34 of the patients with retinochoroiditis patients for up to age ≥10 years and observed appropriate school performance in 28 of the patients.
The research was limited in that it was a retrospective study and was comprised almost exclusively of patients treated in the first year of life. It, therefore, did not have statistical power to assess the effect of presence of treatment.
Lago EG, Endres MM, Scheeren MFDC, Fiori HH. Ocular outcome of Brazilian patients with congenital toxoplasmosis. Pediatr Infect Dis J. 2021;40(1):e21-e27. doi:10.1097/INF.0000000000002931.