Current Practices in Ocular Toxoplasmosis: A Survey of Brazilian Uveitis Specialists

Ocul Immunol Inflamm. 2018;26(2):317-323. doi: 10.1080/09273948.2016.1215471. Epub 2016 Sep 6.

Abstract

Purpose: To describe treatment practices for ocular toxoplasmosis among members of the Brazilian Uveitis Society.

Methods: An online questionnaire sent to specialists, between October 2014 and March 2015.

Results: Most respondents (67.9%) treat all active cases. Most specialists consider visual acuity <20/200 (88.2%), severe vitreous inflammation (94.1%), and ocular disease during acquired infection (88.2%) as absolute indications for treatment. Systemic steroids are associated with anti-toxoplasmic therapy in most cases by 50.9% of the respondents. For immunocompetent individuals, 57.4% of the respondents chose trimethoprim/sulfamethoxazole. Classical therapy (sulfadiazine/pyrimethamine) is preferred most for patients with central lesions (70.4%), immunosuppression (68.4%), acquired infection (70.4%), and atypical forms (74.1%). For patients with frequent relapses, 84.9% of the respondents preferred antibiotic prophylaxis.

Conclusions: Treatment patterns of ocular toxoplasmosis are not uniform among Brazilian specialists. Most specialists treat all cases of active retinochoroiditis. Typical cases are more frequently treated with trimethoprim/sulfamethoxazole. However, classical therapy is the regimen of choice when lesions are considered more severe.

Keywords: Antibiotics; ocular toxoplasmosis; practices; specialists; survey; treatment; uveitis.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Brazil
  • Glucocorticoids / therapeutic use
  • Health Surveys
  • Humans
  • Ophthalmology
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Pyrimethamine / therapeutic use
  • Specialization
  • Sulfadiazine / therapeutic use
  • Surveys and Questionnaires
  • Toxoplasmosis, Ocular / drug therapy*
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Glucocorticoids
  • Sulfadiazine
  • Trimethoprim, Sulfamethoxazole Drug Combination
  • Pyrimethamine