Eye damage with toxoplasmosis
Last reviewed: 23.04.2024
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Depending on the time of infection, they distinguish congenital and acquired toxoplasmosis.
With congenital toxoplasmosis, the pathological process is more often localized in the central nervous system and the eye. The main characteristic features of congenital lesions of the eye are a significant severity of pathological changes and their combination with congenital defects (anophthalmus, microphthalmus, coloboma of the nipple of the optic nerve, coloboma of the eyelids).
The posterior part of the eye with toxoplasmosis is affected much more often than the anterior, predominantly papillomacular region. Toxoplasmosis is characterized by large coarse, sometimes multiple atrophic foci of irregular shape with deposition of a large amount of pigment, mainly along the edges of the focus. Against the background of the focus can be seen retinal vessels and vessels of the choroid. Vessels of choroid are strongly changed, sclerized.
In a number of cases, with congenital toxoplasmosis, there may be a single chorioretinal focus in the macular or paramacular region, but other, smaller foci can often be found near it at the periphery.
In the case of recurrence of the disease, along with the old, fresh foci appear.
Isolated retinitis in congenital toxoplasmosis is rare. They proceed with the phenomena of pronounced exudation, sometimes they end with exudative retinal detachment.
The current of acquired toxoplasmosis is in most cases easier. The disease is detected with the help of serological methods in a mass population survey. In the case of fresh retinal lesions in the macular or papillomacicular area, a round focus of light gray or gray-greenish color appears, larger than the diameter of the optic disc, which leads to the vitreous. The borders are washed away due to retinal edema. Almost always, such foci are surrounded by a hemorrhage band. Sometimes, at some distance from the hearth, hemorrhages appear as dots or small spots of red color. Relapses of hemorrhages at the edges of the focus indicate the activity of the process. A successful outcome is observed infrequently. Most patients have relapses. With toxoplasmosis, retinal perifilebtion, 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 apparatus, blood.
Diagnosis based on clinical signs is often accompanied by significant difficulties. Serological reactions should be used.
Treatment is carried out by sulfanilamide preparations in combination with daraprim (domestic drug - chloride) by cycles according to the generally accepted scheme.
Locally appoints retrobulbar injections of lincomycin 25 mg and gentamicin 20 mg each, as well as a solution of dexamethasone 0.3-0.5 ml daily for 10 days, mydriatic remedies for preventive purposes.
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