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Toxoplasma retinochoroiditis
Uvea
Key Points
- •Toxoplasma retinochoroiditis is the most common cause of infectious posterior uveitis worldwide - classic appearance: focal white retinitis adjacent to old pigmented scar (headlight in the fog)
- •The retina is the primary target (retinochoroiditis, not chorioretinitis); tissue cysts containing bradyzoites persist indefinitely and reactivate to tachyzoites
- •Never start corticosteroids without antiparasitic cover - steroids alone cause fulminant reactivation; start anti-Toxoplasma therapy 48–72h before adding steroids
- •Classic triple therapy: pyrimethamine + sulfadiazine + folinic acid (NOT folic acid); alternatives include TMP-SMX, azithromycin, clindamycin
- •The POINT trial demonstrated that long-term TMP-SMX prophylaxis reduces recurrence from 23.8% to 6.6% over 12 months
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17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations