Congenital toxoplasmosis: long-term follow-up

Area of Science:

• Ophthalmology
• Infectious Diseases
• Pediatrics

Background:

• Congenital toxoplasmosis is a significant health concern in Europe, with a high incidence rate.
• A substantial percentage of affected infants experience severe outcomes, including mortality or lasting damage.

Purpose of the Study:

• To investigate the long-term ocular complications of congenital toxoplasmosis.
• To assess the incidence and nature of chorioretinitis scars and uveitis in affected children.
• To compare ocular findings in children with and without congenital toxoplasmosis.

Main Methods:

• Longitudinal follow-up of infants diagnosed with congenital toxoplasmosis for up to 16 years.
• Ophthalmic examinations to detect chorioretinitis scars and other visual impairments.
• Comparison with a control group of children without congenital toxoplasmosis but with acquired toxoplasmosis antibodies.

Main Results:

• Approximately 70% of infants with congenital toxoplasmosis developed chorioretinitis scars within 16 years, with relapses occurring in both treated and untreated individuals.
• Scars near the macula pose a significant risk to vision, and 1-2% of children developed vision-impairing uveitis.
• No chorioretinitis scars were observed in the control group, despite a high prevalence of acquired toxoplasmosis antibodies.

Conclusions:

• Congenital toxoplasmosis leads to significant long-term ocular morbidity, including vision-threatening chorioretinitis scars and uveitis.
• Current prevention strategies, including vaccination and prenatal screening with safe therapies, remain inadequate.
• The high incidence and severe sequelae underscore the urgent need for effective prevention and management of congenital toxoplasmosis.