Ocular Toxoplasmosis in Immunocompetent Adults: A Review of Published Cases
DOI:
https://doi.org/10.5281/zenodo.22279550Keywords:
Ocular toxoplasmosis, Retinochoroiditis, Posterior uveitis, Toxoplasma gondii, ImmunocompetentAbstract
Background: Ocular toxoplasmosis is a leading cause of infectious posterior uveitis, but published evidence specific to
immunocompetent adults derives largely from regional cohorts, outbreak reports and small trials. Objective: To review published case reports, case series, cohort studies and trials of ocular toxoplasmosis in immunocompetent adults. Methods: Narrative review of case reports, case series, observational cohorts, randomised trials and systematic reviews. Findings: Disease burden varies markedly by region, with waterborne and foodborne outbreaks producing clusters of acquired retinochoroiditis and strain genotype influencing severity. Aqueous humour testing (Goldmann-Witmer coefficient, immunoblot, trimethoprim-sulfamethoxazole, pyrimethamine-sulfadiazine and intravitreal clindamycin-dexamethasone produce broadly equivalent outcomes; prophylaxis reduces recurrence during treatment, but this benefit narrows by ten years. Conclusions: Management should be individualised given the limited superiority evidence among regimens, weighing corticosteroid timing and prophylaxis duration against modest but real risks documented in the literature.
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