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| Autor | Cifuentes-González, Carlos | |
| Autor | Rojas-Carabali, William | |
| Autor | Pérez, Álvaro Olate | |
| Autor | Carvalho, Érika | |
| Autor | Valenzuela, Felipe | |
| Autor | Miguel-Escuder, Lucía | |
| Autor | Ormaechea, María Soledad | |
| Autor | Heredia, Milagros | |
| Autor | Baquero-Ospina, Pablo | |
| Autor | Adan, Alfredo | |
| Autor | Curi, Andre | |
| Autor | Schlaen, Ariel | |
| Autor | Alejandro Urzua, Cristhian | |
| Autor | Couto, Cristóbal | |
| Autor | Arellanes, Lourdes | |
| Autor | de-la-Torre, Alejandra | |
| Fecha de acceso | 2023-06-02T02:18:20Z | |
| Fecha de disponibilización | 2023-06-02T02:18:20Z | |
| Fecha de publicación | 2023 | |
| Referencia | CIFUENTES-GONZÁLEZ, Carlos et al. Risk factors for recurrences and visual impairment in patients with ocular toxoplasmosis: A systematic review and meta-analysis. PLoS One, v. 18, n. 4, p. 1-31, Apr. 2023. | en_US |
| ISSN | 1932-6203 | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/58875 | |
| Idioma | eng | en_US |
| Editor | Public Library of Science | en_US |
| Derechos de autor | open access | en_US |
| Título | Risk factors for recurrences and visual impairment in patients with ocular toxoplasmosis: A systematic review and meta-analysis | en_US |
| Tipo del documento | Article | en_US |
| DOI | 10.1371/journal.pone.0283845 | |
| Resumen en Inglés | Background: Ocular toxoplasmosis (OT) is caused by the parasite Toxoplasma gondii. OT is the leading cause of posterior uveitis globally; it is a recurrent disease that may result in visual impairment and blindness. This systematic review and meta-analysis aim to summarize and evaluate the risk factors for recurrences, visual impairment, and blindness described in the literature worldwide. Methods and findings: We performed a systematic literature search in PubMed, Embase, VHL, Cochrane Library, Scopus, and DANS EASY Archive. All studies reporting patients with clinically and serologically confirmed OT presenting any clinical or paraclinical factor influencing recurrences, visual impairment, and blindness were included. Studies presenting secondary data, case reports, and case series were excluded. An initial selection was made by title and abstract, and then the studies were reviewed by full text where the eligible studies were selected. Then, the risk of bias was assessed through validated tools. Data were extracted using a validated extraction format. Qualitative synthesis and quantitative analysis were done. This study was registered on PROSPERO (CRD42022327836). Results: Seventy two studies met the inclusion criteria. Fifty-three were summarized in the qualitative synthesis in three sections: clinical and environmental factors, parasite and host factors, and treatment-related factors. Of the 72 articles, 39 were included in the meta-analysis, of which 14 were conducted in South America, 13 in Europe, four in Asia, three multinational, two in North America and Central America, respectively, and only one in Africa. A total of 4,200 patients with OT were analyzed, mean age ranged from 7.3 to 65.1 year of age, with similar distribution by sex. The frequency of recurrences in patients with OT was 49% (95% CI 40%-58%), being more frequent in the South American population than in Europeans. Additionally, visual impairment was presented in 35% (95% CI 25%-48%) and blindness in 20% (95% CI 13%-30%) of eyes, with a similar predominance in South Americans than in Europeans. On the other hand, having lesions near the macula or adjacent to the optic nerve had an OR of 4.83 (95% CI; 2.72-8.59) for blindness, similar to having more than one recurrence that had an OR of 3.18 (95% CI; 1.59-6.38). Finally, the prophylactic therapy with Trimethoprim/Sulfamethoxazole versus the placebo showed a protective factor of 83% during the first year and 87% in the second year after treatment. Conclusion: Our Systematic Review showed that clinical factors such as being older than 40 years, patients with de novo OT lesions or with less than one year after the first episode, macular area involvement, lesions greater than 1 disc diameter, congenital toxoplasmosis, and bilateral compromise had more risk of recurrences. Also, environmental and parasite factors such as precipitations, geographical region where the infection is acquired, and more virulent strains confer greater risk of recurrences. Therefore, patients with the above mentioned clinical, environmental, and parasite factors could benefit from using prophylactic therapy. | en_US |
| Afiliación | Neuroscience Research Group. Neurovitae Center for Neuroscience. Institute of Translational Medicine. Escuela de Medicina y Ciencias de la Salud. Universidad del Rosario. Bogotá, Colombia. | en_US |
| Afiliación | Neuroscience Research Group. Neurovitae Center for Neuroscience. Institute of Translational Medicine. Escuela de Medicina y Ciencias de la Salud. Universidad del Rosario. Bogotá, Colombia. | en_US |
| Afiliación | Laboratory of Ocular and Systemic Autoimmune Diseases. Faculty of Medicine. University of Chile. Santiago, Chile. | en_US |
| Afiliación | Oswaldo Cruz Foundation. National Institute of Infectious Disease. Clinical Research Laboratory of Infectious Diseases in Ophthalmogy. Rio de Janeiro, RJ, Brazil. | en_US |
| Afiliación | Laboratory of Ocular and Systemic Autoimmune Diseases. Faculty of Medicine. University of Chile. Santiago, Chile. | en_US |
| Afiliación | Hospital Clinic of Barcelona. Clinic Institute of Ophthalmology. University of Barcelona. Barcelona, Spain. | en_US |
| Afiliación | Department of Ophthalmology. Hospital de Clinicas Jose de San Martin. Universidad de Buenos Aires. Buenos Aires City, Argentina / Department of Ophthalmology. Hospital Universitario Austral. Buenos Aires, Argentina. | en_US |
| Afiliación | Department of Ophthalmology. Hospital de Clinicas Jose de San Martin. Universidad de Buenos Aires. Buenos Aires City, Argentina / Department of Ophthalmology. Hospital Universitario Austral. Buenos Aires, Argentina. | en_US |
| Afiliación | Inflammatory Eye Disease Clinic, Dr. Luis Sanchez Bulnes" Hospital. Asociación para Evitar la Ceguera en México. Mexico City, Mexico. | en_US |
| Afiliación | Hospital Clinic of Barcelona. Clinic Institute of Ophthalmology. University of Barcelona. Barcelona, Spain / Red de Investigación en Inmunología Ocular de Latinoamérica (RIOLAT). | en_US |
| Afiliación | Oswaldo Cruz Foundation. National Institute of Infectious Disease. Clinical Research Laboratory of Infectious Diseases in Ophthalmogy. Rio de Janeiro, RJ, Brazil / Red de Investigación en Inmunología Ocular de Latinoamérica (RIOLAT). | en_US |
| Afiliación | Department of Ophthalmology. Hospital de Clinicas Jose de San Martin. Universidad de Buenos Aires. Buenos Aires City, Argentina / Department of Ophthalmology. Hospital Universitario Austral. Buenos Aires, Argentina / Red de Investigación en Inmunología Ocular de Latinoamérica (RIOLAT). | en_US |
| Afiliación | Laboratory of Ocular and Systemic Autoimmune Diseases. Faculty of Medicine. University of Chile. Santiago, Chile / Red de Investigación en Inmunología Ocular de Latinoamérica (RIOLAT) / Faculty of Medicine. Clinica Alemana-Universidad del Desarrollo. Santiago, Chile. | en_US |
| Afiliación | Department of Ophthalmology. Hospital de Clinicas Jose de San Martin. Universidad de Buenos Aires. Buenos Aires City, Argentina / Red de Investigación en Inmunología Ocular de Latinoamérica (RIOLAT). | en_US |
| Afiliación | Inflammatory Eye Disease Clinic, Dr. Luis Sanchez Bulnes" Hospital. Asociación para Evitar la Ceguera en México. Mexico City, Mexico / Red de Investigación en Inmunología Ocular de Latinoamérica (RIOLAT). | en_US |
| Afiliación | Neuroscience Research Group. Neurovitae Center for Neuroscience. Institute of Translational Medicine. Escuela de Medicina y Ciencias de la Salud. Universidad del Rosario. Bogotá, Colombia / Red de Investigación en Inmunología Ocular de Latinoamérica (RIOLAT). | en_US |
| Palavras clave en Inglês | Ocular toxoplasmosis (OT) | en_US |
| Palavras clave en Inglês | Parasite | en_US |
| Palavras clave en Inglês | Toxoplasma gondii | en_US |
| Palavras clave en Inglês | Systematic Review | en_US |
| Palavras clave en Inglês | Risk of recurrences | en_US |
| e-ISSN | 1932-6203 |
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