Cataract incidence, pathology may vary in children with congenital toxoplasmosis, study suggests

There appears to be a substantial variability in the presentation, morphology and progression of cataracts associated with congenital toxoplasmosis, according to an analysis of data from the National Collaborative Chicago-based Congenital Toxoplasmosis Study.

“Associated intraocular pathology was an important cause of morbidity,” the authors said.

Veena Arun, MD, and colleagues at Northwestern University and the University of Chicago treated 134 congenital toxoplasmosis patients with pyrimethamine, sulfadiazine and leukovorin, and evaluated results to establish the incidence and pathology of cataracts associated with the infection.

Of the 134 patients who underwent treatment during the first postnatal year, cataracts occurred in 27 eyes of 20 patients (11.6%), the authors noted.

Of the 27 cataracts, 14 were present at birth and 13 developed postnatally.

“Locations of the cataracts included anterior polar (three eyes), anterior subcapsular (six eyes), nuclear (five eyes), posterior subcapsular (seven eyes) and unknown (six eyes),” the authors reported.

Thirteen cataracts were partial, nine were total, and five were of unknown complexities, according to the study.

Twelve cataracts remained stable, and 12 progressed; progression was not determined in three cases.

Of the 27 eyes with cataracts, five eyes had cataract surgery, and two eyes subsequently developed glaucoma.

“Sixteen eyes of 11 patients had retinal detachment and cataract. All eyes with cataracts had additional ocular lesions,” the study authors said.

The study is published in the December issue of Journal of American Association for Pediatric Ophthalmology and Strabismus.