1
|
Lakhmawar P, Kelgaonkar A, Patel A, Khalsa A, Basu S. Role of IgG avidity in eyes with active Toxoplasma retinochoroiditis. Indian J Ophthalmol 2024; 72:S601-S605. [PMID: 38324620 PMCID: PMC11338399 DOI: 10.4103/ijo.ijo_3000_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/27/2023] [Indexed: 02/09/2024] Open
Abstract
PURPOSE To study the role of Toxoplasma IgG avidity in evaluating the stage of systemic infection during manifestation as toxoplasma retinochoroiditis and its clinical implications in eastern India. METHODS Retrospective chart review of Toxoplasma retinochoroiditis cases with Toxoplasma serology for IgG, IgM, and IgG avidity. RESULTS Included in this study were 17 eyes of 17 patients who had active retinitis located in the macula (14), mid-periphery (2), or periphery (1). They were either primary lesions (12) or reactivations (5). All the cases had Toxoplasma IgG positive; one case had IgM positivity, while all the cases had high IgG avidity values. IgG avidity had a positive correlation with the duration of symptoms. CONCLUSION We observed high IgG avidity values in active retinochoroiditis in both primary ocular Toxoplasmosis and reactivation subgroups. These results indicate a late ocular manifestation after initial systemic infection with a possible incubation period ranging from 5 weeks to 5 months.
Collapse
Affiliation(s)
- Pratik Lakhmawar
- L. V. Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar, Odisha, India
| | - Anup Kelgaonkar
- L. V. Prasad Eye Institute, Mithu Tulsi Chanrai Campus, Bhubaneswar, Odisha, India
| | - Anamika Patel
- L. V. Prasad Eye Institute, GMR Varalaxmi Campus, Visakhapatnam, Andhra Pradesh, India
| | - Ashish Khalsa
- Uveitis, Vitreous and Retina Services, C. L. Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Soumyava Basu
- Uveitis, Vitreous and Retina Services, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, India
| |
Collapse
|
2
|
Kelgaonkar A, Patel A. Round bodies in the outer plexiform layer in eyes with active Toxoplasma retinochoroiditis. BMJ Case Rep 2023; 16:e255661. [PMID: 37666565 PMCID: PMC10481744 DOI: 10.1136/bcr-2023-255661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023] Open
Affiliation(s)
- Anup Kelgaonkar
- Vitreo-Retina and uveitis services, LV Prasad Eye Institute Bhubaneswar Campus, Bhubaneshwar, Odisha, India
| | - Anamika Patel
- Vitreoretina and Uveitis Services, LV Prasad Eye Institute GMR Varalakshmi Campus, Visakhapatnam, Andhra Pradesh, India
| |
Collapse
|
3
|
Agarwal A, Pichi F, Invernizzi A, Grewal DS, Singh RB, Upadhyay A. Stepwise approach for fundus imaging in the diagnosis and management of posterior uveitis. Surv Ophthalmol 2023; 68:446-480. [PMID: 36724831 DOI: 10.1016/j.survophthal.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 01/30/2023]
Abstract
An array of retinochoroid imaging modalities aid in comprehensive evaluation of the immunopathological changes in the retina and choroid, forming the core component for the diagnosis and management of inflammatory disorders such as uveitis. The recent technological breakthroughs have led to the development of imaging platforms that can evaluate the layers of retina and choroid and the structural and functional alteration in these tissues. Ophthalmologists heavily rely on imaging modalities such as dye-based angiographies (fluorescein angiography and indocyanine green angiography), optical coherence tomography, fundus autofluorescence, as well as dye-less angiography such as optical coherence tomography angiograph,y for establishing a precise diagnosis and understanding the pathophysiology of the diseases. Furthermore, these tools are now being deployed with a 'multimodal' approach for swift and accurate diagnosis. In this comprehensive review, we outline the imaging platforms used for evaluation of posterior uveitis and discuss the organized, algorithmic approach for the assessment of the disorders. Additionally, we provide an insight into disease-specific characteristic pathological changes and the established strategies to rule out disorders with overlapping features on imaging.
Collapse
Affiliation(s)
- Aniruddha Agarwal
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Department of Ophthalmology, Maastricht University Medical Center+, Maastricht, The Netherlands; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA.
| | - Francesco Pichi
- Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Science "Luigi Sacco", Luigi Sacco Hospital, University of Milan, Milan, Italy; Discipline of Ophthalmology, The University of Sydney, Save Sight Institute, Sydney Medical School, Sydney, New South Wales, Australia
| | - Dilraj S Grewal
- Duke Eye Center, Duke University School of Medicine, Durham, North Carolina, USA
| | - Rohan Bir Singh
- Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA; Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands; Ophthalmology and Visual Sciences, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Awaneesh Upadhyay
- Department of Ophthalmology, EyeQ Super-specialty Hospitals, Noida, Uttar Pradesh, India
| |
Collapse
|
4
|
Shah MS, Pradhan AK, Khalsa A, Kelgaonkar A. Mimickers of punctate inner retinal toxoplasmosis on optical coherence tomography. BMJ Case Rep 2022; 15:e251024. [PMID: 35728912 PMCID: PMC9214394 DOI: 10.1136/bcr-2022-251024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 11/03/2022] Open
Affiliation(s)
- Miloni Suketu Shah
- Vitreo-retina, LV Prasad Eye Institute Bhubaneswar Campus, Bhubaneshwar, Odisha, India
| | - Atish Kumar Pradhan
- Vitreo-retina, LV Prasad Eye Institute Bhubaneswar Campus, Bhubaneshwar, Odisha, India
| | | | - Anup Kelgaonkar
- Vitreo-retina, LV Prasad Eye Institute Bhubaneswar Campus, Bhubaneshwar, Odisha, India
| |
Collapse
|
5
|
Affiliation(s)
- Emmett T Cunningham
- The Department of Ophthalmology, California Pacific Medical Center, San Francisco, California, USA.,The Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA.,Proctor Foundation, UCSF School of MedicineThe Francis I., San Francisco, California, USA
| | - Derrick P Smit
- Division of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Manfred Zierhut
- Centre for Ophthalmology, University Tuebingen, Tuebingen, Germany
| |
Collapse
|