[Diagnosis and treatment of ocular toxoplasmosis : a survey of German-speaking ophthalmologists].

BACKGROUND/PURPOSE: Ocular toxoplasmosis is the most frequent cause of posterior uveitis in Germany. The purpose of this survey was to evaluate current strategies in the management of ocular toxoplasmosis by uveitis specialists in Germany.

METHODS

An itemized questionnaire including clinical case reports with authentic photographs was distributed to physician members (n=40) of the German Uveitis Society. In addition, members were categorized regarding their clinical background, professional affiliation and experience with ocular toxoplasmosis.

RESULTS

The completed questionnaire was returned by 72% (29/40) of the members. According to the answers, the majority (70%) of responders base their diagnosis of ocular toxoplasmosis on clinical examination and serological findings. Although a positive IgM titre or increasing IgG titres support the diagnosis only in cases of recently acquired disease, these are reported to support the diagnosis by 58 and 41%, respectively. Invasive procedures such as aqueous humour analysis are performed by 59% of colleagues to establish the diagnosis in selected patients. A total of six antimicrobial agents were reported for treatment in different regimens for typical clinical conditions in patients with recurrent toxoplasmic retinochoroiditis. The combination of pyrimethamine and sulfadiazine is the most commonly used (48%), followed by clindamycin (38%).

CONCLUSIONS

Our survey indicates the lack of a "gold standard" for diagnosis and medical treatment in ocular toxoplasmosis. Further efforts have to be undertaken towards a better distribution of available information and to determine strategies for providing standards of continuously updated diagnostic and therapeutic recommendations for routine clinical practice.