Risk of Visual Impairment in Children with Congenital Toxoplasmic Retinochoroiditis
| Autor: | Hooi Kuan Tan, Alison Salt, Ruth Gilbert, Miles Stanford, Kristina Teär-Fahnehjelm, Dorthe Schmidt, Nicole Ferret |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
Visual acuity genetic structures Eye disease Visual impairment Posterior pole Vision Disorders Visual Acuity Toxoplasmosis Congenital Lesion Vision disorder Risk Factors Ophthalmology Humans Medicine Prospective Studies Child Toxoplasmosis Ocular business.industry Infant Newborn Chorioretinitis Infant medicine.disease eye diseases Ophthalmoscopy Child Preschool medicine.symptom business Visually Impaired Persons Retinopathy |
| Zdroj: | American Journal of Ophthalmology. 144:648-653.e2 |
| ISSN: | 0002-9394 |
| DOI: | 10.1016/j.ajo.2007.07.013 |
| Popis: | Purpose Reliable information is needed to counsel parents of children with congenital toxoplasmosis regarding the long-term risk of visual impairment resulting from ocular toxoplasmosis. Design Prospective cohort study of children with congenital toxoplasmosis identified by prenatal or neonatal screening. Methods After three years of age, ophthalmologists reported the site of retinochoroidal lesions and visual acuity and parents reported visual impairment. An ophthalmologist predicted the child's vision based on the last retinal diagram. Selection biases were minimized by prospective enrollment and data collection, high rates of follow-up, and exclusion of referred cases. Results Two hundred and eighty-one of 284 infected children who underwent ophthalmic examinations were followed up to a median age of 4.8 years. One in six children (49/281; 17%) had at least one retinochoroidal lesion, two-thirds of whom (32/49; 65%) had a lesion at the posterior pole. In children with retinochoroiditis who had visual acuity measured after 3 years of age, 94% (31/33) had normal vision in the best eye (6/12 Snellen or better), as did 91% of those with a posterior pole lesion (21/23). Analyses based on affected eyes showed that 42% (29/69) had a posterior pole lesion, of which just more than half (15/29, 52%) had normal vision, as did 84% (16/19) of eyes with a peripheral lesion alone. Vision predicted by the ophthalmologist was moderately sensitive (59%) but overestimated impairment associated with posterior pole lesions. Of 44 children with information on acuity, four (9%) had bilateral visual impairment worse than 6/12 Snellen. Conclusions Severe bilateral impairment occurred in 9% of children with congenital toxoplasmic retinochoroiditis. Half the children with a posterior pole lesion and one in six of those with peripheral lesions alone were visually impaired in the affected eye. |
| Databáze: | OpenAIRE |
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