RESUMO
The diagnosis of ocular toxoplasmosis is mainly clinical, based in the presence of focal necrotizing retinochoroiditis often associated with a preexistent chorioretinal scar, and variable involvement of the vitreous, retinal blood vessels, optic nerve, and anterior segment of the eye. Recognition of this clinical spectrum of toxoplasmic retinochoroiditis is crucial, but other infectious, noninfectious, and neoplastic entities should also be considered in the differential diagnosis. Investigations such as serological tests, polymerase chain reaction of ocular fluids, and assessment of intraocular antibody synthesis are helpful in uncertain cases. This article provides an overview of the differential diagnosis of ocular toxoplasmosis, focusing on the most important entities to be considered and emphasizing distinctive features of each one of them in the clinical setting. Ocular toxoplasmosis has multiple clinical manifestations, which partially overlap with those of other entities and these should be carefully considered when making the differential diagnosis, particularly in less typical cases.
Assuntos
Toxoplasmose Ocular/diagnóstico , Coriorretinite/congênito , Coriorretinite/diagnóstico , Coriorretinite/parasitologia , Diagnóstico Diferencial , Endoftalmite/diagnóstico , Endoftalmite/microbiologia , Infecções Oculares Bacterianas/diagnóstico , Infecções Oculares Fúngicas/diagnóstico , Neoplasias Oculares/diagnóstico , Herpes Simples , Herpes Zoster , Humanos , Linfoma/diagnóstico , Macula Lutea/patologia , Doenças Retinianas/diagnóstico , Doenças Retinianas/virologia , Síndrome de Necrose Retiniana Aguda/diagnóstico , Síndrome de Necrose Retiniana Aguda/parasitologia , Neoplasias da Retina/diagnóstico , Retinite/parasitologia , Sífilis/diagnóstico , Tuberculose Ocular , Uveíte Posterior/diagnóstico , Uveíte Posterior/microbiologia , Corpo VítreoRESUMO
26 patients with active posterior uveitis were studied by methodologies for the confirmation of leptospirosis. ELISA-IgG was positive in 10 patients and MAT in 21. Leptospiras were observed in blood and urine. The results suggest that posterior uveitis may be caused by pathogenic leptospiras.