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Focal chorioretinitis in Thailand.
Kessara Pathanapitoon1, Paradee Kunavisarut, Aniki Rothova
1*Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Thailand; and †Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands.
Retina (Philadelphia, Pa.)
|August 10, 2013
Summary
Focal chorioretinitis (FCR) in Thailand is strongly associated with active Toxoplasma gondii infection, indicated by high IgG antibody levels. Unlike typical cases, these patients often lack old scars and show distinct retinal arteritis patterns.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Focal chorioretinitis (FCR) is an ocular inflammatory condition.
- Ocular toxoplasmosis is a common cause of posterior uveitis.
- Understanding the clinical presentation and serological markers of FCR is crucial for diagnosis and management.
Purpose of the Study:
- To characterize the clinical features of patients diagnosed with focal chorioretinitis (FCR).
- To evaluate the serological status for Toxoplasma gondii in patients with FCR.
- To compare FCR patients with other forms of uveitis.
Main Methods:
- A cohort of 25 patients with FCR was identified from 593 uveitis cases.
- Control group comprised 127 patients with posterior or panuveitis without FCR.
- Enzyme-linked immunosorbent assay (ELISA) was used to detect anti-Toxoplasma gondii IgG and IgM antibodies.
Main Results:
- 84% of FCR patients (21/25) had positive anti-Toxoplasma gondii IgG, compared to 11% (14/127) in controls (P < 0.001).
- 76% of FCR patients (19/25) showed high IgG levels (>600 IU), absent in controls (P < 0.001).
- Unilateral FCR with vitritis was common; chorioretinal scars (28%) and retinal arteritis (36%) were less frequent than expected.
Conclusions:
- High anti-Toxoplasma gondii IgG levels in Thai FCR patients suggest active systemic infection.
- The absence of old scars and presence of retinal arteritis differ from typical ocular toxoplasmosis in Western populations.
- These findings highlight regional variations in the clinical manifestation of ocular toxoplasmosis.
