gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Prognostic factors for the long-term development of ocular lesions in 327 children with congenital toxoplasmosis

Meeting Abstract

  • corresponding author J. Garweg - Department of Ophthalmology, University of Bern, Inselspital, Bern/CH
  • C. Binquet - Laboratoire de Biostatistique, INSERM EPI 01-06, Faculté de Médecine, Dijon/F
  • M. Wallon - Service de Parasitologie, Hôpital de la Croix-Rousse, Lyon/F
  • C. Quantin - Laboratoire de Biostatistique, INSERM EPI 01-06, Faculté de Médecine, Dijon/F
  • L. Kodjikian - Service d'Ophtalmologie, Hôpital de la Croix-Rousse, Lyon/F
  • J. Fleury - Service d'Ophtalmologie, Hôpital de la Croix-Rousse, Lyon/F
  • F. Peyron - Service de Parasitologie, Hôpital de la Croix-Rousse, Lyon/F
  • M. Abrahamowicz - Department of Epidemiology and Biostatistics, McGill University, Division of Clinical Epidemiology, Montreal General Hospital, Montreal/CDN

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.15.02

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dog2004/04dog292.shtml

Veröffentlicht: 22. September 2004

© 2004 Garweg et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective

To identify the high-risk factors associated with the development of ocular lesions in a cohort of children with congenital toxoplasmosis (CT), irrespective of their gestational age at the time of maternal infection.

Methods

Children were managed according to a standardized protocol and monitored for up to 14 years at the Croix-Rousse Hospital, Lyon, France. Cox model and a flexible regression, spline-based method were used for the analysis of influencing factors.

Results

During a median follow-up time of 6 years, 79 of the 327 children (24%) had at least one retinochoroideal lesion. No bilateral impairment of visual acuity was observed. The risk of a child developing ocular disease was higher when mothers were infected early during pregnancy. CT diagnosis prior to or at birth, the presence of non-ocular manifestations at baseline and premature birth were additionally associated with ocular manifestation.

Conclusions

The time of fetal contamination is one factor for a more severe course of congenital toxoplasmosis. Early diagnosis, non-ocular organ manifestations and premature birth all indicate a more severe prenatal course of infection, which may be associated with a higher maternal parasite blood load resulting in a higher fetal inoculum. The latter may then be an independent risk factor for the further course. If this interpretation gains support using quantitative measures to define the parasite load in placenta and amnion fluid, it will provide a rational basis for an earliest possible aggressive antiparasitic therapy for the mother and her unborn child.