Richa, Singh (2011) Role of oral azithromycin in the treatment of ocular toxoplasmosis. Masters thesis, Madras Medical College, Chennai.
|
Text
2203001richasingh.pdf Download (2MB) | Preview |
Abstract
INTRODUCTION Toxoplasmosis is the most common cause of posterior uveitis in the immunocompetent individuals. It is estimated that at least 500 million people worldwide are infected with this organism. In the developing world its prevalence is probably underestimated. Traditionally thought to be a self-limiting retinochoroiditis, ocular toxoplasmosis can cause sight threatening complications .In infants and in immunosuppressed individuals it can be associated with potentially fatal systemic toxoplasmosis.Earlier believed to be mostly a reactivation of infection acquired in utero, evidence shows that acquired infection is more common than previously thought. It is one of the few uveitis for which we can potentially make a definite diagnosis. The host – organism interrelationship has a influence on the disease manifestations. A variety of diagnostic and therapeutic measures are being researched to aid in managing the disease. EPIDEMIOLOGY An estimated half of the world’s population is infected with toxoplasmosis. It is believed to affect at least 10% of the adults in the northern temperate countries and more than half the people in the mediterranean and the tropical nations. 20 -70% of the general population has a positive serology for the organism. AIM OF THE STUDY To study the effect of oral Azithromycin on the lesions of ocular toxoplasmosis on 50 patients with respect to Reduction in vitreous haze Change in the morphology of the retinal lesion Appearance of any new lesions To compare the characteristics, namely lesion size and its associated vitreous haze, of lesions which heal by 6 weeks with those which do not heal by 9 weeks. CONCLUSION Ocular toxoplasmosis is a very common disease in immunocompetent people and causes significant visual morbidity in a functionally productive population. Although mostly self limiting, to date prevention of recurrent attacks is not feasible35. as most of the drugs used are active against the tachyzoite form and spare the cyst form. Azithromycin 500 mg b.d for a period of 3 weeks is well tolerated and has considerable efficacy in the treatment. In a disease like ocular toxoplasmosis which is essentially self limiting in most immunocompetent individuals, antimicrobials should be prescribed only if truly justified.Azithromycin does bring about an earlier resolution (4-6 weeks) in a disease which would otherwise last for 10 weeks or longer and handicap the person. However, it seems that it has better action when the lesions are small and inflammation not very intensive. It is being proposed as one of the drugs apart from Atovaquone to be active against the cyst form of the parasite and therefore may prevent recurrences.24 It is also devoid of any major side effects unlike the drugs used in the triple and quadruple regime.Azithromycin is also readily available and economically reasonable for most patients. All these points that to the fact that it is a reasonable alternative to the drugs and at times may even prove better than them. This study is a small interventional study carried out on a small population for a short period of time. In order to judge the drug’s true benefits and disadvantages a larger number of people should be followed for a longer time. Comparison studies with other treatment modalities are also needed. The aspect which needs to be addressed to with greater urgency is the prevention of recurrence as it is this which significantly compromises the patient’s vision. Finally, it must be emphasised that is no drug is perfect and all have their positive and negative aspects. The patient’s response depends not only on the treatment but also on a variety of other factors like the organism’s strain, host’s immune response and lesion size. Therefore keeping all these factors in mind, the disease requires greater research into its pathogenesis and search for a superior treatment.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | oral azithromycin; ocular toxoplasmosis |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Devi S |
| Date Deposited: | 31 Jul 2017 07:01 |
| Last Modified: | 31 Jul 2017 07:01 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2382 |
Actions (login required)
 |
View Item |
