Toxoplasmosis-associated optic neuropathies: a systematic review and meta-analysis of clinical characteristics, diagnosis, and outcomes.
Bahareh Basirpour, Mohammad Zarei, Hanieh Ahmadi et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis examined optic neuropathies associated with ocular toxoplasmosis (OT), combining observational studies and case reports. Across 41 studies, including 8 observational studies with 652 OT patients, the pooled prevalence of optic neuropathies was 14.39% (95% CI: 5.22-27.11%); excluding outlier studies, it was 9.78%. Case reports most often described optic disc swelling. ELISA was the main immunologic diagnostic tool reported, and pyrimethamine-based regimens were the most frequently used treatments. The authors emphasize that this presentation can resemble other optic neuropathies and may be underrecognized.
Key findings
- Across 8 observational studies including 652 OT patients, pooled optic neuropathy prevalence was 14.39% (95% CI: 5.22-27.11%).
- Sensitivity analysis excluding outlier studies yielded a pooled prevalence of 9.78%.
- Among case reports, optic disc swelling was the most common clinical sign; ELISA was the primary immunologic diagnostic tool reported.
- Pyrimethamine-based regimens were the most frequently used treatments in the reviewed case reports.
Why it matters
Optic nerve involvement in ocular toxoplasmosis may be difficult to distinguish from other infectious or inflammatory optic neuropathies. Awareness of this association can support consideration of toxoplasmosis in the differential diagnosis and timely evaluation, while the pooled estimate indicates that optic neuropathy is a clinically relevant manifestation among patients with OT.
What to keep in mind
The evidence included 33 case reports and only 8 observational studies; the pooled prevalence was sensitive to outlier studies.