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Ophthalmic outcomes of congenital toxoplasmosis followed until adolescence.
[congenital toxoplasmosis]
Congenital
toxoplasmosis
(
CT
)
can
elicit
severe
damage
to
several
organs
,
especially
the
eye
,
and
may
be
manifested
at
birth
or
later
.
We
assessed
the
long
-term
ocular
prognosis
in
a
cohort
of
congenitally
infected
children
treated
according
to
a
standardized
protocol
and
monitored
for
up
to
22
years
.
This
prospective
study
included
confirmed
cases
of
CT
,
which
were
identified
by
obligatory
antenatal
screening
at
the
Lyon
(
France
)
reference
center
between
1987
and
2008
.
Data
obtained
through
ocular
examinations
were
recorded
on
a
standardized
form
and
confirmed
by
an
independent
external
committee
.
Risk
factors
for
retinochoroiditis
were
identified
by
using
a
multivariable
Cox
model
and
a
flexible
model
that
accounted
for
changes
in
the
factor
effects
during
follow-up
.
A
total
of
477
of
485
infected
live-born
children
were
followed
for
a
median
of
10
.
5
years
(
75
th
percentile
:
15
.
0
years
)
.
During
the
follow-up
,
142
patients
(
29
.
8
%
)
manifested
at
least
1
ocular
lesion
.
Lesions
were
unilateral
in
98
individuals
(
69
.
0
%
)
and
caused
no
vision
loss
in
80
.
6
%
.
Lesions
were
first
manifested
at
a
median
age
of
3
.
1
(
0
.
0
-
20
.
7
)
years
.
In
48
(
33
.
8
%
)
of
the
children
,
recurrences
or
new
ocular
lesions
occurred
up
to
12
years
after
the
appearance
of
the
first
lesion
.
Early
maternal
infection
and
confirmation
of
CT
in
children
,
prematurity
,
and
nonocular
CT
lesions
at
baseline
were
associated
with
a
higher
risk
of
retinochoroiditis
.
Although
the
consequences
of
CT
are
rarely
severe
in
treated
children
,
regular
postnatal
monitoring
is
nevertheless
justified
because
of
the
lifelong
persisting
risk
of
new
ocular
manifestations
.