[Congential toxoplasmosis and ocular involvement. A review with 6 case reports]

A review is presented of the ocular affections in congenital toxoplasmosis. The epidemiological, pathogenetic and pathological conditions are reviewed together with the clinical manifestations and the diagnostic and therapeutic possibilities. On the basis of incidence investigations and knowledge from the literature, it must be assumed that approximately 190 infants with congenital toxoplasmosis are born annually in Denmark. Only approximately 15% of the infections will be symptom-producing and will be diagnosed neonatally, but more than 85% of the children with congenital toxoplasmosis will develop chorioretinitis on delivery or later in life and this will frequently cause reduction in vision or blindness. Congenital toxoplasmosis must be regarded as the commonest cause of chorioretinitis and it is probable that congenital toxoplasmosis and chorioretinitis due to toxoplasmosis are considerably underdiagnosed in Denmark. Treatment of congenital toxoplasmosis from birth improve the prognosis. Toxoplasmosis should be suspected in all cases of chorioretinitis. When antibodies to Toxoplasma gondii are demonstrated and the clinical picture is compatible with toxoplasmosis and when there is no other diagnosis, anti-Toxoplasma treatment should be considered. It is important to inform pregnant women about prophylactic measures. If investigations for toxoplasmosis were introduced in the prenatal or perinatal examinations, treatment could be initiated from birth and the diagnosis could be confirmed by possible activation of the chorioretinitis at a later date. Six case reports are presented.