An epidemiologic study of 100 cases of toxoplasmic uveitis: implications for diagnosis and prevention.

An epidemiologic study of 100 patients with active chorioretinitis, positive Sabin-Feldman methylene-blue dye-test, and favourable response to antitoxoplasmic drugs (spiramycin) was undertaken to establish a basis for rapid clinical diagnosis and institution of preventive measures for toxoplasmic uveitis. Eighty-two of the 100 patients, but only 19 of 100 controls, gave positive histories of exposure to likely sources of toxoplasmosis, such as hunting and handling of wild game, ingestion of raw meat, etc. Seventy-six of these 82 patients had positive toxoplasmin skin tests, but all subsequently had positive dye-tests. The important practical conclusion was reached that all cases with active chorioretinitis, positive toxoplasmin skin test, or history of exposure to known reservoirs of toxoplasmosis should be treated immediately, as dye-tests in such cases will almost invariably be positive. This clinical approach greatly improves the visual prognosis of toxoplasmic chorioretinitis, since specific therapy need not be delayed for several weeks until the result of the dye-test is known.