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AbstractSO.20.04 Ocular prognosis in children with congenital toxoplasmosis Garweg J. G.1, Wallon M.2, Peyron F.2
1Swiss Eye Institute, Bern, Schweiz; 2Hopital Croix Rousse, Universite de Lyon II, Lyon, Frankreich Objective: In an attempt to understand and interpret recent data on the effect of pre- and postnatal treatment, we tried to compare the data of our cohort of 430 children with CT to those published by other groups.
Methods: 30.2% (130) of our patients developed OT lesions during a median follow-up of 12 years comparing well to recently published data with ranges from 19-39% after follow-up times of 1-4.5 years.
Results: Only two children of our own series or 1.6% of all children showed a bilateral affection of their visual function. These results were achieved in our as well as in utmost of other recently published cohorts with a combination of in utero - and postpartal treatment throughout the first year of life and are markedly better than reported for historical cases who were untreated or treated for shorter periods. This view is also supported by the results of the SYROCOT metaanalysis which reports a weak evidence for an association between early prenatal treatment and reduced risk of congenital toxoplasmosis. Nevertheless, treatment efficacy is still a concern, since there is no obvious effect of antenatal tratement on the incidence of organ manifestations, and progression of eye lesions may be observed in a number of eyes despite therapy during the first year of life.
Conclusions: In the absence of controlled studies we have to assume that there exists a small but eventually relevant benefit of pre- and postnatal treatment. Although not all children do well with treatment, the outcomes of recently published cohorts indicate the importance of diagnosis and treatment of infants with congenital toxoplasmosis until the results of larger randomised controlled clinical trials provide valid evidence of the potential benefit of pre- and postnatal treatment.
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