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When biology supports clinical diagnosis: review of techniques to diagnose ocular toxoplasmosis
  1. Valentin Greigert1,
  2. Elsa Di Foggia2,
  3. Denis Filisetti1,3,4,
  4. Odile Villard1,3,4,
  5. Alexander W Pfaff1,3,4,
  6. Arnaud Sauer1,2,
  7. Ermanno Candolfi1,3,4
  1. 1Institut de Parasitologie et Pathologie Tropicale, Université de Strasbourg, Strasbourg, France
  2. 2Service d'Ophthalmologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
  3. 3Service de Parasitologie et Mycologie Médicales, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
  4. 4Centre National de Référence «Toxoplasmose» – Pôle sérologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
  1. Correspondence to Dr Valentin Greigert, Université de Strasbourg, Institut de Parasitologie et Pathologie Tropicale, Strasbourg, France; valentin.greigert{at}gmail.com

Abstract

Toxoplasmosis is a common infection whose worldwide prevalence is estimated at 30%, with large disparities across the world. Among infected subjects, the prevalence of ocular toxoplasmosis (OT) is, however, limited to about 2% in Europe and 17% in South America. In France, it is estimated that about 1 000 000 patients present either active OT or subsequent chorioretinal scars. Toxoplasmagondii is the first cause of posterior uveitis worldwide, responsible for retinochoroiditis, at times associated with anterior uveitis. To date, there is no consensus yet on how to diagnose OT, which is often based only on clinical presentation. Nevertheless, OT-associated symptoms are often atypical and misleading. Over the last 20 years, tremendous progress has been made in biological tools, enabling parasitologists to confirm the diagnosis in most suspected cases of OT. Using anterior chamber puncture, a safe and fast procedure, ophthalmologists sample aqueous humour for analysis using multiple techniques in order to reach high specificity and sensitivity in OT diagnosis. In this article, we present the different techniques available for the biological diagnosis of OT, along with their characteristics, and propose a diagnostic algorithm designed to select the best of these techniques if clinical examination is not sufficient to ascertain the diagnosis.

  • t. gondii
  • ocular toxoplasmosis
  • retinochoroiditis
  • review
  • diagnosis
  • eye infection
  • parasite
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Footnotes

  • VG and EDF contributed equally.

  • AS and EC contributed equally.

  • Contributors All the authors were involved in the review of the literature, redaction of the draft, correction and validation of the manuscript. EC and AS imagined and designed the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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