This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features!
Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

NIH NLM Logo
Log in
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Oct 14;13(10):898.
doi: 10.3390/pathogens13100898.

Ocular Toxoplasmosis: Advances in Toxoplasma gondii Biology, Clinical Manifestations, Diagnostics, and Therapy

Affiliations
Review

Ocular Toxoplasmosis: Advances in Toxoplasma gondii Biology, Clinical Manifestations, Diagnostics, and Therapy

Miki Miyagaki et al. Pathogens. .

Abstract

Toxoplasma gondii, an obligate intracellular parasite, is a globally prevalent pathogen capable of infecting a wide range of warm-blooded animals, including humans. Ocular toxoplasmosis (OT), a severe manifestation of T. gondii infection, can lead to potentially blinding complications. This comprehensive review delves into the current understanding of T. gondii biology, exploring its complex life cycle, diverse transmission routes, and strain diversity. This article provides an in-depth analysis of the clinical manifestations of OT, which can result from both congenital and acquired infections, presenting a spectrum of signs and symptoms. The review examines various diagnostic strategies employed for OT, including clinical examination, multimodal imaging techniques such as fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA), as well as laboratory tests including serology and molecular methods. Despite extensive research, the specific mechanisms underlying ocular involvement in T. gondii infection remain elusive, and current diagnostic options have limitations. Moreover, the treatment of active and recurrent OT remains a challenge. While existing therapies, such as antimicrobial agents and immunosuppressants, can control active infections, they do not offer a definitive cure or completely prevent recurrence. The clinical endpoints for the management of active and recurrent OT are also not yet well-established, and the available treatment methods carry the potential for adverse effects. This article highlights the need for future research to elucidate the pathogenesis of OT, investigate genetic factors influencing susceptibility to infection, and develop more sensitive and specific diagnostic tools. Enhancing global surveillance, implementing robust prevention strategies, and fostering multidisciplinary collaborations will be crucial in reducing the burden of OT and improving patient outcomes. This comprehensive review aims to provide a valuable resource for clinicians, researchers, and policymakers, contributing to a better understanding of T. gondii infection and its impact on ocular health.

Keywords: Diagnostic techniques; Ocular toxoplasmosis; Pathogenesis research; Toxoplasma gondii.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
A 73-year-old woman diagnosed with chronic bilateral ocular toxoplasmosis presents with distinct findings in both eyes. (a) In the left eye (oculus sinister), a circular and well-defined macular retinochoroidal lesion is noted, characterized by irregularly scattered areas of atrophy and pigment deposition within the lesion. (b) In the right eye (oculus dexter), a macular retinochoroidal lesion is also observed, associated with choroidal neovascularization (CNV) and diffuse exudation. (Adapted with permission from Ref. [3]. 2022, Fabiani S et al.).
Figure 2
Figure 2
A 46-year-old man with ocular toxoplasmosis in left eye. The macula exhibits a necrotic scar lesion with a satellite lesion in close proximity.
Figure 3
Figure 3
A 30-year-old woman, 6 months pregnant, presents with active recurrent toxoplasmic retinochoroiditis and its evolution following treatment. (A) The early phase of fundus fluorescein angiography (FFA) demonstrates progressive hyperfluorescence associated with the recurrent lesion. (B) The late phase of FFA reveals continued hyperfluorescence with centrifugal peripheral staining of the recurrent lesion. (Adapted from Ref. [37] 2020, Azar G et al.).
Figure 4
Figure 4
An 86-year-old woman with ocular toxoplasmosis (acquired infection) presents with significant findings in her right eye. (A) The color fundus image reveals a mixture of lesions and choroidal atrophy in the peripheral region of the right eye (oculus dexter). (B) Fluorescein angiography demonstrates characteristic features: In the early phase, the lesion exhibits hypofluorescence (black center) corresponding to the area of exudation (white arrow).
Figure 5
Figure 5
The left image shows the scan line across a toxoplasmosis lesion, The right image demonstrates a reduction in retinal thickness (white arrow), which is indicative of tissue atrophy in the affected area.
Figure 6
Figure 6
The left image shows the scan line across a toxoplasmosis lesion, The right image displays serous retinal detachment in the macular region (white arrow).

References

    1. Flegr J., Prandota J., Sovičková M., Israili Z.H. Toxoplasmosis—A Global Threat. Correlation of Latent Toxoplasmosis with Specific Disease Burden in a Set of 88 Countries. PLoS ONE. 2014;9:e90203. doi: 10.1371/journal.pone.0090203. - DOI - PMC - PubMed
    1. Kalogeropoulos D., Sakkas H., Mohammed B., Vartholomatos G., Malamos K., Sreekantam S., Kanavaros P., Kalogeropoulos C. Ocular toxoplasmosis: A review of the current diagnostic and therapeutic approaches. Int. Ophthalmol. 2022;42:295–321. doi: 10.1007/s10792-021-01994-9. - DOI - PMC - PubMed
    1. Fabiani S., Caroselli C., Menchini M., Gabbriellini G., Falcone M., Bruschi F. Ocular toxoplasmosis, an overview focusing on clinical aspects. Acta Trop. 2022;225:106180. doi: 10.1016/j.actatropica.2021.106180. - DOI - PubMed
    1. Dubey J.P. Outbreaks of clinical toxoplasmosis in humans: Five decades of personal experience, perspectives and lessons learned. Parasites Vectors. 2021;14:263. doi: 10.1186/s13071-021-04769-4. - DOI - PMC - PubMed
    1. Shapiro K., Bahia-Oliveira L., Dixon B., Dumètre A., de Wit L.A., VanWormer E., Villena I. Environmental transmission of Toxoplasma gondii: Oocysts in water, soil and food. Food Waterborne Parasitol. 2019;15:e00049. doi: 10.1016/j.fawpar.2019.e00049. - DOI - PMC - PubMed

LinkOut - more resources

Full text links
MDPI full text link MDPI Free PMC article
Cite

AltStyle によって変換されたページ (->オリジナル) /