Clinical and multimodal imaging findings and risk factors for ocular involvement in a presumed waterborne toxoplasmosis outbreak, Brazil

• Autor(a) principal: Camilo Brandão-de-Resende
• Data de Publicação: 2020
• Outros Autores: Helena Hollanda Santos, Angel Alessio Rojas Lagos, Camila Munayert Lara, Jacqueline Souza Dutra Arruda, Ana Paula Maia Peixoto Marino, Lis Ribeiro do Valle Antonelli, Ricardo Tostes Gazzinelli, Ricardo Wagner de Almeida Vitor, Daniel Vitor Vasconcelos Santos
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.3201/eid2612.200227; http://hdl.handle.net/1843/51452; https://orcid.org/0000-0001-6713-372X; https://orcid.org/0000-0002-4969-8812; https://orcid.org/0000-0003-2427-7699; https://orcid.org/0000-0002-6747-2024
• topic: Toxoplasmosis; Ocular involvement; Retinochoroiditis; Macular lesions; Bilateral lesions; Toxoplasmose; Toxoplasmose ocular; Coriorretinopatia de birdshot; Traumatismos oculares

In 2015, an outbreak of presumed waterborne toxoplasmosis occurred in Gouveia, Brazil. We conducted a 3-year prospective study on a cohort of 52 patients from this outbreak, collected clinical and multimodal imaging findings, and determined risk factors for ocular involvement. At baseline examination, 12 (23%) patients had retinochoroiditis; 4 patients had bilateral and 2 had macular lesions. Multimodal imaging revealed 2 distinct retinochoroiditis patterns: necrotizing focal retinochoroiditis and punctate retinochoroiditis. Older age, worse visual acuity, self-reported recent reduction of visual acuity, and presence of floaters were associated with retinochoroiditis. Among patients, persons >40 years of age had 5 times the risk for ocular involvement. Five patients had recurrences during follow-up, a rate of 22% per person-year. Recurrences were associated with binocular involvement. Two patients had late ocular involvement that occurred >34 months after initial diagnosis. Patients with acquired toxoplasmosis should have long-term ophthalmic follow-up, regardless of initial ocular involvement.