Ocular toxoplamoi after the fifth decade

PURPOE: To decribe the clinical feature in patient preenting with ocular toxoplamoi after the fifth decade and to analyze laboratory finding in comparion to uveiti hitory and clinical data. DEIGN: Propective conecutive obervational cae erie. METHOD: A propective clinical analyi of 27 conecutive patient older than 50 year of age with primary or recurrent ocular toxoplamoi wa performed during a period of 8 year. Thee cae account for 12% of all ocular toxoplamoi cae irrepective of age indexed in our intitution during the ame period. Paired erum and aqueou humor ample were teted for anti-Toxoplama gondii IgG, IgM, and IgA antibodie. The preence of T. gondii DNA in aqueou humor wa determined by polymerae chain reaction followed by DNA hydridization method. REULT: Although imilar in age, two group were ditinguihed clinically: 12 patient (44%) preented with uual form of retinochoroiditi (mean ± D, 1.6 ± 0.5 dik area [DA] in ize); 15 patient (56%) preented with atypical leion, greater than 3 DA in ize (mean ± D, 5.0 ± 2.0 DA). The econd group howed a higher rate of complication (P = .028) and a poorer viual outcome (P = .015). Twenty-four patient (89%) had intraocular IgG production, 17 (63%) had intraocular IgA production, 3 (11%) had intraocular IgM production, and 12 (44%) had a poitive T. gondii DNA detection. CONCLUION: After the fifth decade, ocular toxoplamoi remain an important caue of poterior uveiti. The combination of antibody detection by immunocapture tet with T. gondii DNA detection, both in aqueou humor, allowed the diagnoi of toxoplamic infection in the atypical cae with large ocular leion