Visual Outcomes in Presumed Congenital Foveal Toxoplasmosis.

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.

journal_name

Am J Ophthalmol

authors

Reynolds MMM,Chisholm SAM,Schroeder R,Lueder GT

doi

10.1016/j.ajo.2020.01.034

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

9-13

eissn

0002-9394

issn

1879-1891

pii

S0002-9394(20)30052-0

journal_volume

214

pub_type

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