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Histopathological Features of Ocular Toxoplasmosis in the Fetus and Infant
Fiona Roberts, MD;
Marilyn B. Mets, MD;
David J. P. Ferguson, PhD;
Richard O'Grady, MD;
Carol O'Grady;
Philippe Thulliez, PhD;
Antoine P. Brézin, MD;
Rima McLeod, MD
Arch Ophthalmol. 2001;119:51-58.
Background Ocular disease is a frequent manifestation of congenital Toxoplasma gondii infection. There are only limited data available
in the literature concerning early stages of this disease in fetuses and infants.
The purpose of our study was to characterize histopathological features in
the eyes of 10 fetuses and 2 infants with congenital toxoplasmosis.
Methods Fifteen eyes from 10 fetuses, 3 eyes from 2 premature infants, and both
eyes from a 2-year-old child with congenital toxoplasmosis were examined by
light microscopy. Immunohistochemical analysis to identify inflammatory cells
and T gondii antigens was performed. The findings
in infected eyes were compared with those of age-matched control eyes.
Results Retinitis (10/18 eyes), retinal necrosis (4/18 eyes), disruption of
the retinal pigment epithelium (12/18 eyes), and choroidal inflammation and
congestion (15/18 eyes) were characteristic findings. Optic neuritis was present
in 5 of 8 fetal eyes with associated optic nerve available for evaluation.
An eye obtained from a 32-week-old fetus showed retinal rosettes at the edge
of a scar. T cells predominated in retinal lesions and choroid. Parasites
were identified by immunohistochemical analysis in 10 of 18 eyes.
Conclusions Ocular toxoplasmosis causes irreversible damage to the retina in utero.
The fetus and infant mount inflammatory responses that may contribute to ocular
damage. These findings have important implications for serological screening
programs and in utero therapy.
From the Department of Medicine, Michael Reese Hospital, Chicago, Ill,
and the Department of Pathology, Victoria Infirmary, Glasgow, Scotland (Dr
Roberts); Department of Ophthalmology, Children's Memorial Hospital, Northwestern
University, Chicago (Dr Mets); Nuffield Department of Pathology, John Radcliffe
Hospital, Oxford University, Oxford, England (Dr Ferguson); Department of
Ophthalmology, Northwestern University Medical School, Chicago (Dr R. O'Grady
and Ms C. O'Grady); Toxoplasmosis Laboratory, Institute of Puericulture of
Paris, Paris, France (Dr Thulliez); Department of Ophthalmology, Hopital Cochin,
Paris (Dr Brézin); and the Departments of Ophthalmology, Medicine,
and Pathology and Committees on Immunology and Genetics, The University of
Chicago (Dr McLeod).
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Gilbert and Dezateux
Arch. Dis. Child. 2006;91:629-631.
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Norose et al.
IOVS 2003;44:4375-4381.
ABSTRACT
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