Eye damage in toxoplasmosis

Depending on the time of infection, a distinction is made between congenital and acquired toxoplasmosis.

In congenital toxoplasmosis, the pathological process is most often localized in the central nervous system and the eye. The main characteristic features of congenital eye lesions are the significant severity of pathological changes and their combination with congenital defects (anophthalmos, microphthalmos, coloboma of the optic nerve papilla, coloboma of the eyelids).

The posterior part of the eye is affected by toxoplasmosis much more often than the anterior part, mainly the papillomacular region. Toxoplasmosis is characterized by large, rough, sometimes multiple, irregularly shaped atrophic lesions with a large amount of pigment deposited, mainly along the edges of the lesion. Retinal vessels and choroidal vessels may be visible against the background of the lesion. The choroidal vessels are greatly altered and sclerotic.

In some cases of congenital toxoplasmosis, there may be a single chorioretinal lesion in the macular or paramacular region, but often other, smaller lesions can be found near it on the periphery.

In the event of a relapse of the disease, new lesions appear along with the old ones.

Isolated retinitis in congenital toxoplasmosis is rare. It occurs with the phenomena of pronounced exudation, sometimes ending in exudative retinal detachment.

The course of acquired toxoplasmosis is milder in most cases. The disease is detected using serological methods during mass examination of the population. In case of fresh retinal damage, a round lesion of light gray or gray-greenish color appears in the macular or papillomacular area, larger than the diameter of the optic nerve disk, protruding into the vitreous body. The borders are washed out due to retinal edema. Almost always, such foci are surrounded by a border of hemorrhages. Sometimes, at some distance from the lesion, hemorrhages appear in the form of dots or small red spots. Recurrence of hemorrhages at the edges of the lesion indicate the activity of the process. A favorable outcome is observed infrequently. Most patients have relapses. With toxoplasmosis, retinal periphlebitis, retinal vein thrombosis, paresis and paralysis of the oculomotor muscles can develop. The eye disease is usually combined with changes in the nervous and cardiovascular systems, lymphatic system, and blood.

Diagnosis based on clinical signs is often associated with significant difficulties. Serological reactions must be used.

Treatment is carried out with sulfonamide drugs in combination with daraprim (a domestic drug - chloridin) in cycles according to the generally accepted scheme.

Locally, retrobulbar injections of lincomycin at 25 mg and gentamicin at 20 mg are prescribed, as well as a dexamethasone solution at 0.3-0.5 ml daily for 10 days, mydriatic agents for prophylactic purposes.

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