Counseling patients diagnosed with a potentially recurrent disease regarding their risk of a recurrence is difficult. Despite the fact that toxoplasma retinochoroiditis is generally considered the most common posterior uveitis, information on which to base discussions about its recurrence is lacking. To that end, the authors of this article attempt to provide important information about the pattern of recurrent disease in ocular toxoplasmosis.
They longitudinally examined 143 patients with toxoplasma retinochoroiditis, extracting data on recurrence patterns over time. Interestingly enough, the authors found that recurrences did not occur randomly, as is commonly believed, but rather in a distinctive clustered pattern.
This study offers key information that can be used when counseling patients, including that recurrence is more likely during the period immediately following an episode and becomes less likely with greater time since the most recent attack, decreasing by 72 percent with the passage of each decade since the most recent episode. In addition, each decade of additional age of a patient when an initial episode occurred decreased the likelihood of a recurrence by 15 percent, although there was a greater risk of recurrence in individuals older than age 40 compared with those age 40 and younger.
Caveats to the study's conclusions are that the study population was exclusively from the Netherlands, so whether the findings can be extrapolated to other populations is not known, and the results apply to only to patients who are not HIV-positive.
Dr. Read is a consultant to Lux Biosciences Inc. Dr. Read receives grant support from the EyeSight Foundation of Alabama, the National Eye Institute, and Research to Prevent Blindness.