Clinical characteristics associated with complications and poor visual outcomes in ocular toxoplasmosis: Analysis of 853 patients: complications and visual outcomes in ocular toxoplasmosis.

Abstract

Purpose: To describe the clinical characteristics of ocular toxoplasmosis (OT) in Colombia and identify factors associated with ocular complications and poor visual outcomes.

Design: Multicenter cross-sectional study.

Methods: Demographic and clinical characteristics-including disease course, uveitis location (according to the Standardization of Uveitis Nomenclature), type of inflammation (presumed granulomatous vs. non-granulomatous), ocular complications (cataract, glaucoma, macular edema, retinal detachment, vitreous hemorrhage, epiretinal membrane, band keratopathy), and visual outcomes-were collected from patients with OT across seven ophthalmological centers in Colombia. A subgroup analysis included patients with documented lesion characteristics. Logistic regression, adjusted for age and sex, assessed factors associated with ocular complications (any of the complications above), moderate-to-severe vision impairment (BCVA <20/60 to >20/400 in the better-seeing eye), and blindness (BCVA ≤20/400 in the better-seeing eye).

Results: 853 OT patients (431 females, 422 males) were included, with a mean age of 38 ± 17.9 years. OT predominantly manifested as acute (57%), unilateral (79%), and non-granulomatous uveitis (78%). Sixty percent (512) had a final BCVA >20/60. Factors associated with ocular complications included age >50 (OR=4.75; p<0.001), retinochoroiditis with vitritis/AC inflammation (OR=2.85; p<0.001), presumed granulomatous uveitis (OR=2.04; p<0.001), persistent disease or early recurrences (sooner than 3 months) (OR=3.24; p<0.001), and recurrences first occurring after 3 months (OR=1.79; p=0.009). Blindness was linked to age <16 (OR=1.94; p=0.025), >50 (OR=1.74; p=0.001), bilateral involvement (OR=1.53; p=0.017), and zone 1 lesions (OR=8.25; p=0.015).

Conclusion: OT in Colombia shows worse outcomes compared to other regions. Extreme ages, bilateral involvement, retinochoroiditis with vitritis/AC inflammation, and zone 1 lesions are major risk factors for complications and poor visual outcomes.