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ARTICLES
Year : 1973  |  Volume : 21  |  Issue : 1  |  Page : 16-18

Toxoplasmic uveitis in India


Department of Ophthalmology, Maulana Azad Medical College and Associated Hospitals, New Delhi, India

Correspondence Address:
S.R.K Malik
Department of Ophthalmology, Maulana Azad Medical College and Associated Hospitals, New Delhi
India
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Source of Support: None, Conflict of Interest: None


PMID: 4793001

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How to cite this article:
Malik S, Gupta A K, Gupta D K. Toxoplasmic uveitis in India. Indian J Ophthalmol 1973;21:16-8

How to cite this URL:
Malik S, Gupta A K, Gupta D K. Toxoplasmic uveitis in India. Indian J Ophthalmol [serial online] 1973 [cited 2020 Nov 27];21:16-8. Available from: https://www.ijo.in/text.asp?1973/21/1/16/31425

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Table 1

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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 Top


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 Top


The observations have been sum­marized in [Table - 1],[Table - 2],[Table - 3].

Positive culture of toxoplasmosis was obtained only in one case.


  Discussion Top


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 Top


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.



 
 
    Tables

  [Table - 1], [Table - 2], [Table - 3]



 

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