Usefulness of immunoblotting and Goldmann-Witmer coefficient for biological diagnosis of toxoplasmic retinochoroiditis.

Toxoplasmosis is a frequent cause of retinochoroiditis. Although the diagnosis relies mainly on ophthalmological examination, biological approaches are particularly useful in patients with atypical lesions. In a prospective study to determine the value of immunoblotting and immune load calculation in the diagnosis of active toxoplasmic retinochoroiditis, aqueous humor samples from 21 patients with retinochoroiditis and 5 control patients with cataracts were tested. Immune load was calculated on the basis of intraocular antibody production. The immune load ratio between aqueous humor and serum (Goldmann-Witmer coefficient) was significant (i.e. >2) in 9 of the 17 (53%) patients with retrospectively documented toxoplasmic retinochoroiditis. Immunoblotting suggested local antibody production in 10 of 17 (59%) patients. The combination of the two techniques gave a sensitivity of 71% (12/17). Both techniques were negative in the four patients in whom the final diagnosis of toxoplasmic retinochoroiditis was negative and in the five patients with cataracts. These results confirm the value of combining these two techniques. Moreover, immunoblotting has the advantages of being easy to perform and of requiring a very small sample.