|Year : 1973 | Volume
| Issue : 1 | Page : 16-18
Toxoplasmic uveitis in India
S.R.K Malik, AK Gupta, DK Gupta
Department of Ophthalmology, Maulana Azad Medical College and Associated Hospitals, New Delhi, India
Department of Ophthalmology, Maulana Azad Medical College and Associated Hospitals, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Malik S, Gupta A K, Gupta D K. Toxoplasmic uveitis in India. Indian J Ophthalmol 1973;21:16-8
Aetiological diagnosis of uveitis is often difficult and presumptive. Aetiology of uveitis has varied from time to time in different countries based upon the nature of investigations carried out by a particular investigator. WooDS 21,22 in his survey of uveitis in 1941 did not come across a single case of uveitis from toxoplasmosis while in 1960 he observed that toxoplasmosis was responsible for 36% of cases of uveitis. Since then many reports on toxoplasmic uveitis have appeared in the lierature. The incidence of toxoplasmic uveitis according to various reports varies from 0.5% to 26% (BANNETT, 2 ALVARO, 1 BROCK-HURST, 6 BERGAUST 5 and RHISNS, SUIE AND McCoy. From India, SINGH 18 reported a case of healed toxoplasmic chorioretinitis while RAWAL JHALA AND PATEL, 14 reported seven cases of toxoplasmic uveitis. MALIK, GUPTA, PRAKASH AND CHERIAN 11 and BATTA, PRAKASH, SHARMA, AGARWAL AND MOHAN 3 reported one case each of toxoplasmic uveitis where the organisms were cultured from the , lymph node and parotid gland respectively. BATTA, SHARMA, AGARWAL, CHOWDHRY AND PRAKASH 3 demonstrated antibodies against toxoplasma by haemagglutination test in 13.1 per cent out of the 288 cases of uveitis investigated by them. The present communication deals with our experience of 258 cases of uveitis who have been investigated for toxoplasmosis.
| Material and Methods|| |
258 cases of uveitis attending the uveitis clinic of Irwin Hospital, New Delhi were subjected to the following tests for toxoplasmosis in addition to the other routine investigations for uveitis.
Toxoplasmin skin test: It was performed in 258 cases of uveitis and 137 normal cases. The reaction showing induration and erythema of more than 5 mm. was considered significant.
Sabin-Feldman dye test: This test was carried out in 88 cases of uveitis and 44 normal cases. JACOB'S8,9 modification of Sabin-Feldman test was followed.
Haemagglutination test: It was carried out in 77 cases of uveitis according to Jacob's modification of the technique described by Jacobs and Lunde (1957).
Toxoplasmosis culture: This was carried out in white mice.
| Observations|| |
The observations have been summarized in [Table - 1],[Table - 2],[Table - 3].
Positive culture of toxoplasmosis was obtained only in one case.
| Discussion|| |
In the present series of non-uveitis cases antibodies against toxoplasma could be demonstrated in 5.8% cases by toxoplasmin skin test and in 15.9 per cent cases by the dye test. KALRA 10 in a series of mixed group, found 4% cases positive for toxoplasma by complement fixation test while only 2 cases out of 135 were positive from the pure vegetarean group. RAWAL 15 did not observe any difference in the prevalence of toxoplasma in vegetareans and non-vegetareans. PRAKASH[ 12] demonstrated 14 percent cases positive for toxoplasma by indirect haemagglutination test out of 327 patients where a possibility of toxoplasmosis was entertained.
From the series of uveitis cases, on the basis of the above mentioned investigations, 22 cases of uveitis were attributed to toxoplasmosis. Only those cases of uveitis where two or more than two tests were positive or a single test was strongly positive were considered to be due to toxoplasmosis. Of the 22 cases, 20 cases were of posterior uveitis and 2 cases of panuveitis. BATTA AND OTHERS (1968) demonstrated antibodies against toxoplasma in 13.1 percent cases of uveitis. Maximum number of positive cases (16.1%) was in the chorioretinitis group. The incidence of 8.5 % in the present series is relatively low because of the fact that the criteria of positivity were more rigid.
Incidence of toxoplasmic uveitis in India is relatively low as compared to many other reports-WOODS, JACOBS, WOOD AND COOK 21 (1954) 25%, SCHLEAGEL 17 39%, WOODS 22 37%, BROCKHURST, SCHEPENS AND OKAMURA 6 26% and RHEINS, SUIE AND McCoy 16, 24%. PERKINS 13 observed that 70% of cases of acute posterior uveitis were due to toxoplasmosis.. However, BENNET 2 , STANWORTH AND MCINTYRE 19 , ALVARO 1 , HALLTT, WOLKOWICS, FERIA, LEOPOLD AND WIJEWSKI 7 (1959) URAYAMA 20 AND BERGAUST 5 reported extremely low incidence of toxoplasmic uveitis (0.5 to 1.5%) from the areas surveyed by them. The relatively lower incidence of toxoplasmosis in India could be due to the higher incidence of certain other diseases e.g. tuberculosis in which uveal involvement is common. The incidence of tubercular uveitis in the present series was 44.2%.
| Summary|| |
258 cases of uveitis were investigated for toxoplasmosis. 22 cases of uveitis (8.5%) were attributed to toxoplasmosis. The relatively low incidence of toxoplasmosis has been explained due to higher incidence of tuberculosis where uveal involvement is common.
[Table - 1], [Table - 2], [Table - 3]