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Volume 26, Number 12—December 2020
CME ACTIVITY - Research

Clinical and Multimodal Imaging Findings and Risk Factors for Ocular Involvement in a Presumed Waterborne Toxoplasmosis Outbreak, Brazil1

Camilo Brandão-de-Resende, Helena Hollanda Santos, Angel Alessio Rojas Lagos, Camila Munayert Lara, Jacqueline Souza Dutra Arruda, Ana Paula Maia Peixoto Marino, Lis Ribeiro do Valle Antonelli, Ricardo Tostes Gazzinelli, Ricardo Wagner de Almeida Vitor, and Daniel Vitor Vasconcelos-SantosComments to Author 
Author affiliations: Universidade Federal de Minas Gerais, Belo Horizonte, Brazil (C. Brandão-de-Resende, H.H. Santos, A.A.R. Lagos, C.M. Lara, J.S.D. Arruda, R.W.A, Vitor, D.V. Vasconcelos-Santos); Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte (A.P.M.P. Marino, L.R.V. Antonelli, R.T. Gazzinelli).

Main Article

Table 3

Ocular characteristics, recurrences, and complications of patients with ocular involvement from toxoplasmosis, Brazil*

Age, y/sex
Baseline eye examination
Follow-up findings
Complications
Last VA, mo; result
RC
Right
Left
38/M†
Bilateral
VA 0.0; SLE, AV cells and AC cells (0.5+/4+); FE, multifocal PR and peripheral large FNR
VA 0.0; SLE, AV cells; FE, PR
1 OD recurrence; month 2, satellite active lesion
None
21; 0.0 OU
47/M†
Bilateral
VA 0.2; SLE, AV cells;FE, peripheral large FNR
VA 0.0; SLE, AV cells; FE, multiple peripheral large FNR
1 OD recurrence; month 22, new peripheral scar
Month 22, epiretinal membrane OD
34; 0.0 OU
40/M† Bilateral VA 0.0; SLE, AV cells; FE, multifocal PR VA 0.0; SLE, AV cells;
FE, multifocal PR and peripheral large FNR Multiple recurrences OU;
months 11, 21, and 24, active peripheral lesions; month 27, active peripheral lesion OS Month 21, epiretinal membrane OD; month 27, rhegmatogenous RD OS 36; 0.0 OD, 0.8 OS
48/M†
Bilateral
VA 2.1; SL, EAV cells; FE, macular FNR
VA 0.3; SLE, AV cells;
FE, peripheral FNR
2 recurrences OS; new peripheral scar in months 12 and 15
Month 9, epiretinal membrane OD; month 34, epiretinal membrane OS
34; 1.9 OD, 0.4 OS
43/M†
Unilateral
VA 0.0; SLE, normal; FE, Leber miliary aneurysms
VA 0.7; SLE, fine KP, AC cells 2+/4+, and AV cells; FE, peripheral large FNR

None
36; 0.1 OS
27/M
Unilateral
VA 0.0; SLE, AV cells; FE, PR
VA 0.0; normal SLE and FE

None
23; 0.0 OD
42/M†
Unilateral
VA 0.5; SLE, granulomatous KP, AC cells (3+/4+), AV cells; IOP, 28 mmHg; FE, peripheral large FNR
VA 0.0; normal SLE and FE
1 recurrence OD; month 9, multiple active peripheral lesions OD
Baseline transient IOP elevation OD, 28mmHg
24; 0.0 OD
31/M
Unilateral
VA 0.0; normal SLE and FE
VA 0.0; SLE OS, AV cells; FE, multiple peripheral FNR

None
8; 0.0 OS
50/M†
Unilateral
VA 0.5; SLE, AV cells;
FE, peripheral large FNR
VA 0.0; normal SLE and FE

Month 6, posterior vitreous detachment OD
37; 0.0 OD
47/F†
Unilateral
VA 1.6; SLE, AV cells; FE, macular FNR
VA 0.0; normal SLE and FE

None
37; 1.9 OD
40/M†
Unilateral
VA 0.0; SLE, AV cells; FE, peripheral large FNR
VA 0.0; normal SLE and FE

None
37; 0.0 OD
45/M
Unilateral
VA 0.0; SLE, AV cells; FE, PR
VA 0.0; normal SLE and FE

None
37; 0.0 OD
15/M‡
NA
VA 0.0; normal SLE and FE
VA 0.0; normal SLE and FE
Late ocular involvement; OD VA 0.1; month 34, new peripheral scar
None
34; 0.1 OD
28/F‡ NA VA 0.0; normal SLE and FE VA 0.0; normal SLE and FE Late ocular involvement; OD VA 0.0; month 37, peripheral FNR None 39; 0.0 OD

*Age represents age at detection of first ocular lesion or scar. AC cells, grading of anterior chamber cells according to Standardization of Uveitis Nomenclature (SUN) working group (29); AV cells, anterior vitreous cells; FE, fundus examination; FNR, focal necrotizing retinochoroiditis, large FNR is >3 disk diameters; IOP, intraocular pressure; KP, keratic precipitates; NA, not applicable; OD, oculus dexter (right eye); OS, oculus sinister (left eye); OU, oculus uterque (both eyes); PR, punctate retinochoroiditis; RC, retinochoroiditis; RD, retinal detachment; SLE, slit-lamp examination; VA, visual acuity (log MAR); –, no recurrence or no new lesion.
†Patients with severe ocular involvement, including binocular, macular, or extensive necrotizing retinochoroiditis (>3 disk diameters).
‡Patients with initial normal ophthalmic examination.

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1Presented in part at the 2015 American Uveitis Society Fall meeting, November 15, 2014, Las Vegas, Nevada, USA

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Page updated: November 19, 2020
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