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Oküler Toksoplazmoziste Takip ve Tedavi Sonuçlarımız

Our Results of Follow-up and Treatment in Ocular Toxoplasmosis

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Abstract (2. Language): 
Purpose: To evaluate the importance of clinical findings and treatment modalities in ocular toxoplasmosis. Materials and Methods: We retrospectively evaluated 20 patients who were diagnosed oculer toxoplasmosis between 2003-2009 in Fırat univercity eye clinic. The diagnosis was determined according to the fundus examination and serological findings. Results: Twelve (%60) female and 8 (%40) male of 20 patients were involved and the mean of the patients age was 25 (13-48) years. The mean follow up time was 30 (8-62) months. Twelve (%60) patients had active retinochoroiditis and 8 (%40) patients had retinochoroidal skar. Twelve (%60) patients who had active retinochoroiditis were treated with antiparasitic drugs for 4-6 weeks. Four (%33) of the patients in this grup had foveal lesions and 8 (%66) had foveal lesions as well as peripheral retinal involvement. Ocular findings were observed anterior chamber reaction and keratic precipitates in 12 (%60) patients, posterior synechia in 4 (%20) patients and posterior subcapsuler cataract in 2 (%10) patients. Topical steroid and sikloplejik terapy were aplicated to the twelve (%60) patients who had anterior chamber reaction. Recurrence was observed in 4 (%20) patients. The mean improvement of the visual acuity was 1.8 lines in snellen chart. The anterior chamber reaction and size of the lesion were decreased after the treatment. Conclusion: The diagnosis of oculer toxoplasmosis was determined with clinical and serological findings. Ocular toxoplasmosis can be taken under control by the correct diagnosis and effective treatment. Visual prognosis might be better after the treatment.
Abstract (Original Language): 
Amaç: Oküler toksoplazmozis tanısında klinik bulguların önemini vurgulamak ve tedavi yaklaşımlarını değerlendirmek. Gereç-Yöntem: 2003-2009 tarihleri arasında Fırat Üniversitesi Hastanesi Göz Hastalıkları kliniğinde Oküler toksoplazmozis tanısıyla takip edilen 20 hastanın kayıtları retrospektif olarak incelendi. Tanı serolojik testler ve fundus muayenesinde bulguların varlığı ile konuldu. Bulgular: Çalışmaya dahil edilen 12 (%60) kadın, 8 (%40) erkek hastanın yaş ortalaması 25 (13-48) yıldı. Ortalama takip süreleri 30 (8-62) aydı. On iki (%60) hastada aktif retinokoroidit, 8 (%40) hastada retinokoroidal skar mevcuttu. Aktif retinokoroidit düşünülen 12 (%60) hastaya 4-6 hafta süreyle antiparazitik tedavi uygulandı. Bu hastaların 4 (%33)’ ünde foveal tutulum, 8 (%66)’inde foveal tutulumla birlikte periferik retinada tutulum saptandı. Olgularımızın retina dışı göz bulguları incelendiğinde; 12 (%60) hastada değişen derecelerde ön kamara reaksiyonu ve keratik presipitatlar, 4 (%20) hastada posterior sineşi, 2 (%10) hastada arka subkapsüler katarakta rastlanıldı. Ön kamara reaksiyonu olan 12 (%60) hastaya topikal steroid ve sikloplejik damla tedaviye eklendi. Dört (%20) hastada takip sürecinde nüks gözlendi. Tedavi sonrası görme keskinliği snellen eşeline göre ortalama 1,8 sıra arttı ve tüm olgularda ön kamara reaksiyonunda azalma, lezyon çapında küçülme saptandı. Tartışma: Oküler toksoplazmozis tanısı klinik ve serolojik bulgularla konulmaktadır. Doğru tanı ve tedavi yaklaşımı ile oküler toksoplazmozis kontrol altına alınabilir, görme prognozu üzerindeki olumsuz etkisi azaltılabilir.
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