Late ocular manifestations of systemic acquired toxoplasmosis-an integrative - literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i15.36968

Keywords:

Toxoplasma gondii; Toxoplasmosis, Ocular; Chorioretinitis; Uveitis, posterior.

Abstract

Toxoplasmosis is a disease of infectious origin caused by the protozoan Toxoplasma gondii, and is responsible for several systemic manifestations, following a mild to severe clinical picture of fever, muscle pain, lymph node enlargement, neural involvement and ocular lesions. The ocular toxoplasmosis is responsible for generating an involvement of the macula, the optic nerve, the posterior uvea, generating posterior uveitis, and mainly retinochoroiditis. Toxoplasma is responsible for 50% of the cases of uveitis in Brazil. Therefore, this article aims to review the literature about the main ocular manifestations of systemic toxoplasmosis, focusing on prevalence, incidence, signs and symptoms, and main methods of approach. This is an integrative literature review, and the following databases were used for the research: PUBMED, SCIELO and BVS. The screening process had the following inclusion criteria: articles that answered the guiding question, in English, Portuguese, or Spanish, and between 2017 and 2021. After the searches, a total of 12 articles were obtained for review. Toxoplasma gondii is responsible for the secondary granulomatous inflammatory process in the choroid, and, after the acute phase, a chorioretinal scar with a white center and pigmented edges can be presented as a complication, with the main ocular manifestations being: retinochoroiditis, papillitis, neuroretinitis and scleritis. As a consequence of this ocular trophism, toxoplasma can cause a reduction in visual acuity, mostly less than or equal to 20/200, evolution to partial visual loss or blindness, presence of floaters, increased intraocular pressure, photophobia, hyperemia, simulating conjunctivitis, and visual clouding. The main population affected is the low socioeconomic development and low education associated with a higher risk of exposure to the etiologic agent. Therefore, this study reaffirms the need to continue with new studies in order to prevent diseases and promote health based on the endemicity of each region of the country, promoting integral health care and generating quality of life for these patients.

References

Arruda, S. L. B. (2018). Manifestações clínicas e complicações associadas à toxoplasmose ocular. Dissertação (Mestrado em Ciências) – Universidade de São Paulo, Ribeirão Preto-SP.

Arruda, S. (2021). Clinical manifestations and visual outcomes associated with ocular toxoplasmosis in a Brazilian population. Scientific Reports, v. 11, n. 1, p. 3137. Disponível em: https://www.nature.com/articles/s41598-021-82830-z

Azar, G. (2020). Optical Coherence Tomography Angiography Analysis of Retinal and Choroidal Vascular Networks during Acute, Relapsing, and Quiescent Stages of Macular Toxoplasma Retinochoroiditis. BioMed Research International, v. 2020, p. 4903735. Disponível em: https://pubmed.ncbi.nlm.nih.gov/33015168/ .

Bonamigo, E. L. et al. (2021). Uncommon progression of toxoplasmic papillitis: patient perception and case report. Revista Brasileira de Oftalmologia, v. 80, n. 5, p. e0036–e0036. Disponível em: https://pesquisa.bvsalud.org/portal/resource/pt/biblio-1341157 .

Borges, R. T. et al. (2017). Toxoplasmose e suas repercussões oftalmológicas-uma revisão. Revista de Medicina e Saúde de Brasília, v. 6, n. 2.

Brandão-de-Resende, C. et al. (2020). Clinical and Multimodal Imaging Findings and Risk Factors for Ocular Involvement in a Presumed Waterborne Toxoplasmosis Outbreak, Brazil1. Emerging Infectious Diseases, v. 26, n. 12. Disponível em: https://pubmed.ncbi.nlm.nih.gov/33219657/ .

Burnier Junior., M. N.; Fernandes, B.F. (2014). Anatomia Patológica na Toxoplasmose: aspectos sistêmicos, neurológicos e oculares. In: SOUZA, W., and BELFORT JR., R., comp. Toxoplasmose & Toxoplasma gondii. Rio de Janeiro: Editora Fiocruz, p. 167-208.

Crossetti, M. D. G. O. (2012). Revisão integrativa de pesquisa na enfermagem o rigor cientifico que lhe é exigido. Revista Gaúcha de Enfermagem, v. 33, n. 2, p. 8-9. Disponível em: https://www.scielo.br/j/rgenf/a/9TrSVHTDtDGhcP5pLvGnt5n/?format=pdf&lang=pt.

Do carmo, E. L. et al. (2016). Soroepidemiologia da infecção pelo Toxoplasma gondii no Município de Novo Repartimento, Estado do Pará, Brasil. Revista Pan-Amazônica de Saúde, v. 7, n. 4, p. 79–87. Disponível em: http://scielo.iec.gov.br/scielo.php?script=sci_arttext&pid=S2176-62232016000400010 .

Felix, J. P. F. et al. (2020). Long-term Results of Trimethoprim-Sulfamethoxazole Versus Placebo to Reduce the Risk of Recurrent Toxoplasma gondii Retinochoroiditis. American Journal of Ophthalmology, v. 213, p. 195–202. Disponível em: https://pubmed.ncbi.nlm.nih.gov/31926883/ .

İpek, S. C.; Çakar Ozdal, P.; Kavukçu, S.; Saatci, A. O. (2020). Unilateral Acute Macular Toxoplasmic Chorioretinitis Associated with White Dot-Like Choroidal Involvement Demonstrated on Indocyanine Green Angiography. Turkish Journal of Ophthalmology, v. 50, n. 4, p. 248–251. Disponível em: https://pubmed.ncbi.nlm.nih.gov/32854470/ .

Lv, X.; Yu, P. (2018). Early diagnosis and successful treatment of acquired toxoplasmosis infectious retinochoroiditis. Medicine, v. 97, n. 26. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6039674/ .

Machado, R. A. F.; Bortolli, J. P. de; Bassanezi, F. (2016). Prevalence of chorioretinal scars in angiographics exams. Revista Brasileira de Oftalmologia, v. 75, n. 2. Disponível em: https://www.scielo.br/j/rbof/a/C4RT9wf6v4g5w3YSdZ8WmWr/?format=pdf&lang=pt#:~:text=A%20toxoplasmose%20ocular%20possui%20alta .

Marques, A. et al. (2013). Diagnóstico e Tratamento da Toxoplasmose Ocular em Casos Atípicos. Oftalmologia, v. 37, p. 265-272.

Morais, F. B.; Arantes, T. E. F. E; Muccioli, C.; Allemann, N. (2019). Ultrasonographic characteristics of active ocular toxoplasmosis. Arquivos Brasileiros de Oftalmologia, v. 82, n. 4.

Oréfice, F. et al. (2010). Toxoplasmose ocular adquirida: toxoplasmose ocular pós-natal. Revista Brasileira de Oftalmologia, v. 69, p. 184-207.

Soares, P. V. B. S. (2021). Toxoplasmose sistêmica associada à forma ocular bilateral atípica mimetizando necrose retiniana aguda. Revista Brasileira de Oftalmologia, v. 80, n. 6. Disponível em: https://www.scielo.br/j/rbof/a/cTJmVyndLFpTM65NzNRzbFt/?lang=pt .

The standardization of uveitis nomenclature (sun) working group. (2021). Classification Criteria for Toxoplasmic Retinitis. American Journal of Ophthalmology, v. 228, p. 134-141.

Velasco-Velásquez, S. et al. (2021). Clinical, Socio-economic and Environmental Factors Related with Recurrences in Ocular Toxoplasmosis in Quindío, Colombia. Ophthalmic Epidemiology, v. 28, n. 3, p. 258–264. Disponível em: https://pubmed.ncbi.nlm.nih.gov/33115293/ .

Veronesi, R.; Focaccia, R. (2015). Tratado de Infectologia. Ed.: Atheneu.

Yannuzzi, N. A. et al. (2019). Multimodal Imaging of Punctate Outer Retinal Toxoplasmosis. Ophthalmic Surgery, Lasers & Imaging Retina, v. 50, n. 5, p. 281–287. Disponível em: https://pubmed.ncbi.nlm.nih.gov/31100158/ .

Zhang, S. et al. (2021). Macular pucker, an atypical clinical presentation of ocular toxoplasmosis: a case report. BMC Ophthalmology, v. 21, n. 1.

Published

09/11/2022

How to Cite

AZEVEDO, A. dos R. C.; CORRÊA, G. R. A.; MOREIRA, A. C. L. . Late ocular manifestations of systemic acquired toxoplasmosis-an integrative - literature review. Research, Society and Development, [S. l.], v. 11, n. 15, p. e54111536968, 2022. DOI: 10.33448/rsd-v11i15.36968. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/36968. Acesso em: 17 nov. 2024.

Issue

Section

Review Article