This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (44) Citing Articles via Google Scholar Google Scholar Articles by Wallon, M. Articles by Peyron, F. Search for Related Content PubMed PubMed Citation Articles by Wallon, M. Articles by Peyron, F. Related Collections Infectious Disease & Immunity Related AAP Red Book topics: Toxoplasma gondii Infections... Social Bookmarking                         What's this?

PEDIATRICS Vol. 113 No. 6 June 2004, pp. 1567-1572

Long-Term Ocular Prognosis in 327 Children With Congenital Toxoplasmosis

Martine Wallon, MD, MPH, PhD^*, Laurent Kodjikian, MD, PhD, Christine Binquet, MD, PhD, Justus Garweg, MD^||, Jacques Fleury, MD, Catherine Quantin, MD, PhD and François Peyron, MD, PhD^*

^* Service de Parasitologie, Hôpital de la Croix-Rousse, Lyon, France
Service d’Ophtalmologie, Hôpital de la Croix-Rousse, Lyon, France
Service de Biostatistiques et d’Informatique Médicale, Centre Hospitalier Universitaire, Dijon, France
^|| Department of Ophthalmology, University of Bern, Inselspital, Bern, Switzerland

Objective. Retinochoroiditis is the most frequent consequence of congenital toxoplasmosis. Early diagnosis and treatment are believed to reduce the risk of visual impairment. We report on the clinical evolution of ocular lesions and final visual function in a prospective cohort of congenitally infected children who were identified during monthly maternal prenatal screening.

Methods. The study included 327 congenitally infected children who were monitored for up to 14 years at the Croix Rousse Hospital in Lyon, France. Data on date of maternal infection; time and type of therapy; antenatal, neonatal, and postnatal work-ups; and ocular status were analyzed.

Results. All mothers but 52 had been treated. Pyrimethamine and sulfadiazine was given in utero to 38% of children and after birth to 72% of newborns. Fansidar was given for an average duration of 337 days in all but 2 children. After a median follow-up of 6 years, 79 (24%) children had at least 1 retinochoroidal lesion. In 23 (29%) of them, at least 1 new event had been diagnosed up to 10 years after detection of the first lesions: reactivation of an existing lesion (1 case), new lesion in a previously healthy location (19 cases), or both (3 cases). Fifty-five children had lesions in 1 eye; of the 45 children for whom final visual acuity data were available, 31 (69%) had normal vision. Twenty-four children had lesions in both eyes; of the 21 for whom final visual acuity data were available, 11 had normal vision in both eyes. None had bilateral visual impairment.

Conclusions. Clinicians, parents, and elder children with congenital infection should be informed that late-onset retinal lesions and relapse can occur many years after birth but that the overall ocular prognosis of congenital toxoplasmosis is satisfactory when infection is identified early and treated accordingly.

---

Key Words: Toxoplasma gondii • congenital • ocular • eye • cohort • prenatal screening • prevention

Abbreviations: Ig, immunoglobulin

---

Received for publication Oct 13, 2003; Accepted Feb 2, 2004.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				K. Freeman, H. K. Tan, A. Prusa, E. Petersen, W. Buffolano, G. Malm, M. Cortina-Borja, R. Gilbert, and for the European Multicentre Study on Congenital T Predictors of Retinochoroiditis in Children With Congenital Toxoplasmosis: European, Prospective Cohort Study Pediatrics, May 1, 2008; 121(5): e1215 - e1222. [Abstract] [Full Text] [PDF]

				M. Lefevre-Pettazzoni, A. Bissery, M. Wallon, G. Cozon, F. Peyron, and M. Rabilloud Impact of Spiramycin Treatment and Gestational Age on Maturation of Toxoplasma gondii Immunoglobulin G Avidity in Pregnant Women Clin. Vaccine Immunol., March 1, 2007; 14(3): 239 - 243. [Abstract] [Full Text] [PDF]

				J. Scherrer, M. E Iliev, M. Halberstadt, L. Kodjikian, and J. G Garweg Visual function in human ocular toxoplasmosis Br J Ophthalmol, February 1, 2007; 91(2): 233 - 236. [Abstract] [Full Text] [PDF]

				J E Gomez-Marin and A delaTorre Positive benefit of postnatal treatment in congenital toxoplasmosis Arch. Dis. Child., January 1, 2007; 92(1): 88 - 89. [Full Text] [PDF]

				R Gilbert and C Dezateux Newborn screening for congenital toxoplasmosis: feasible, but benefits are not established. Arch. Dis. Child., August 1, 2006; 91(8): 629 - 631. [Full Text] [PDF]

				D R Schmidt, B Hogh, O Andersen, J Fuchs, H Fledelius, and E Petersen The national neonatal screening programme for congenital toxoplasmosis in Denmark: results from the initial four years, 1999-2002. Arch. Dis. Child., August 1, 2006; 91(8): 661 - 665. [Abstract] [Full Text] [PDF]

				E. Beghetto, A. Spadoni, L. Bruno, W. Buffolano, and N. Gargano Chimeric Antigens of Toxoplasma gondii: Toward Standardization of Toxoplasmosis Serodiagnosis Using Recombinant Products. J. Clin. Microbiol., June 1, 2006; 44(6): 2133 - 2140. [Abstract] [Full Text] [PDF]

				W. Buffolano, E. Beghetto, M. Del Pezzo, A. Spadoni, M. Di Cristina, E. Petersen, and N. Gargano Use of Recombinant Antigens for Early Postnatal Diagnosis of Congenital Toxoplasmosis J. Clin. Microbiol., December 1, 2005; 43(12): 5916 - 5924. [Abstract] [Full Text] [PDF]

				Congenital Toxoplasmosis: Long-Term Eye Findings Journal Watch Infectious Diseases, June 28, 2004; 2004(628): 5 - 5. [Full Text]