Outcome of Ocular Toxoplasmosis in a Paediatric Population

PURPOSE: Toxoplasmosis is the most common cause of infectious uveitis of the posterior segment. Current literature regarding this parasitic ocular infection in children is sparse. In this study, we focused on localisation of retinal infiltration and visual outcome in children and adolescents.

MATERIAL AND METHODS: Single-centre, retrospective study from 2012 to 2021. Patients were divided into three subgroups depending on foveal involvement: (1) direct foveal infiltrate, (2) with extrafoveal infiltrate, either with or (3) without fovea-involving inflammation. The primary outcome was visual acuity (VA) improvement (Snellen, decimal). The secondary outcome was the VA outcome depending on foveal involvement. Wilcoxon signed rank test (SPSS Statistics 26) was used for statistical analysis.

RESULTS: Data of 144 paediatric uveitis cases were identified, with active ocular toxoplasmosis in 21 (14.5%) patients. Data analysis was permitted in 20/21 patients. Oral antibiotic and prednisone therapy and additional topical steroids were initiated if deemed necessary. Overall, VA improved from first presentation (mean 0.5, range hand motion to 1.0) to last follow-up (mean 0.7, range counting fingers to 1.0; p = 0.001). Focusing on the subgroups, the most substantial VA improvement was reported in group 1 (0.042 to 0.30; p = 0.028) and in group 2 (0.62 to 0.9; p = 0.078).

CONCLUSION: In children in adolescence, VA improves the symptoms of in children of fovea involving ocular toxoplasmosis. Direct foveal infiltrate is associated with the lowest visual acuity outcome but also with the most substantial VA improvement.