Surgical management of retinal detachment and macular holes secondary to ocular toxoplasmosis: a systematic review and meta-analysis

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorAMARAL, Dillan Cunha
dc.contributor.authorLANE, Mark
dc.contributor.authorAGUIAR, Eduardo Henrique Cassins
dc.contributor.authorMARQUES, Guilherme Nunes
dc.contributor.authorCAVASSANI, Luiza Visentin
dc.contributor.authorRODRIGUES, Marcio Penha Mortera
dc.contributor.authorALVES, Milton Ruiz
dc.contributor.authorMANSO, Jose Eduardo Ferreira
dc.contributor.authorMONTEIRO, Mario Luiz Ribeiro
dc.contributor.authorLOUZADA, Ricardo Noguera
dc.date.accessioned2024-04-05T19:33:19Z
dc.date.available2024-04-05T19:33:19Z
dc.date.issued2024
dc.description.abstractBackgroundToxoplasma gondii causes ocular toxoplasmosis (OT), involving inflammation, scarring, and retinal complications. The OT complications were retinal detachment (RD), and retinal breakage (RB). Surgical interventions like scleral buckling (SB) and vitrectomy are common. Limited understanding exists of the safety and efficacy of surgical management of RD/RB secondary to OT. Another complication is toxoplasmosis-related macular holes (tMH), with sparse evidence on surgical outcomes. This meta-analysis aims to clarify clinical characteristics, and surgical results, and enhance understanding of RD, RB, and MH secondary to OT.MethodsPubMed, Cochrane, Embase and Web of Science database were queried for retrospective studies, case series and case reports that provided information on RD, RB and MH associated with OT and reported the outcomes of: (1) Retinal reattachment of RD/RB and tMH closure; (2) Best-corrected visual acuity (BCVA) improvement; and (3) Complications. Heterogeneity was examined with I2 statistics. A random-effects model was used for outcomes with high heterogeneity. Statistical analysis was performed using the software R (version 4.2.3, R Foundation for Statistical Computing, Vienna, Austria).ResultsFourteen final studies, comprising a total of 96 patients were analyzed, 81 with RD or RB and 15 with tMH. Overall, surgical management was associated with several advantages: a high rate of retinal reattachment of RD/RB of 97% (95% Confidence Interval [CI] 92-100%; I2 = 0%), retinal reattachment of just RD of 96% (95% CI 89-100%; I2 = 30%) and tMH closure 97% (95% CI 87-100; I2 = 12%). There were significant differences in BCVA after surgeries in studies of RD/RB (MD 0.60; 95% CI 0.35-0.65; I2 = 20%) and MH (MD 0.67; 95% CI 0.50-0.84; I2 = 0%). The overall complication rate associated with surgical procedures in RD/RB secondary to OT was confirmed to be 25%.ConclusionsThe systematic review and meta-analysis showed that the treatment approaches currently in use are effective, with a remarkable rate of retinal reattachment of RD/RB, tMH closure, and substantial improvements in visual acuity. More randomized, long-term studies on disease and surgical factors can provide valuable insights into their impact on anatomical and visual outcomes.eng
dc.description.indexPubMed
dc.description.indexScopus
dc.description.indexDimensions
dc.description.indexWoS
dc.identifier.citationINTERNATIONAL JOURNAL OF RETINA AND VITREOUS, v.10, n.1, article ID 23, 12p, 2024
dc.identifier.doi10.1186/s40942-024-00540-w
dc.identifier.eissn2056-9920
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/58932
dc.language.isoeng
dc.publisherBMCeng
dc.relation.ispartofInternational Journal of Retina and Vitreous
dc.rightsopenAccesseng
dc.rights.holderCopyright BMCeng
dc.subjectOcular toxoplasmosiseng
dc.subjectRetinal detachmenteng
dc.subjectMeta-analysiseng
dc.subjectRetinal breakeng
dc.subjectMacular holeeng
dc.subject.otherglobal reassessmenteng
dc.subject.otherclinical-featureseng
dc.subject.othermemorial-lectureeng
dc.subject.otheroutcomeseng
dc.subject.othermanifestationseng
dc.subject.othervitrectomyeng
dc.subject.otherprognosiseng
dc.subject.otherdiseaseeng
dc.subject.wosOphthalmologyeng
dc.titleSurgical management of retinal detachment and macular holes secondary to ocular toxoplasmosis: a systematic review and meta-analysiseng
dc.typearticleeng
dc.type.categoryrevieweng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryInglaterra
hcfmusp.affiliation.countryisogb
hcfmusp.author.externalAMARAL, Dillan Cunha:Univ Fed Rio De Janeiro, Fac Med, Rio De Janeiro, Brazil
hcfmusp.author.externalLANE, Mark:Moorfields Eye Hosp, London, England
hcfmusp.author.externalAGUIAR, Eduardo Henrique Cassins:Univ Fed Rio De Janeiro, Fac Med, Rio De Janeiro, Brazil
hcfmusp.author.externalMARQUES, Guilherme Nunes:Univ Fed Rio De Janeiro, Fac Med, Rio De Janeiro, Brazil
hcfmusp.author.externalCAVASSANI, Luiza Visentin:Ctr Univ Max Planck, Fac Med, Indaiatuba, Brazil
hcfmusp.author.externalRODRIGUES, Marcio Penha Mortera:Univ Fed Rio De Janeiro, Fac Med, Rio De Janeiro, Brazil
hcfmusp.author.externalMANSO, Jose Eduardo Ferreira:Univ Fed Rio De Janeiro, Fac Med, Rio De Janeiro, Brazil
hcfmusp.citation.scopus0
hcfmusp.contributor.author-fmusphcMILTON RUIZ ALVES
hcfmusp.contributor.author-fmusphcMARIO LUIZ RIBEIRO MONTEIRO
hcfmusp.contributor.author-fmusphcRICARDO NOGUERA LOUZADA
hcfmusp.description.articlenumber23
hcfmusp.description.issue1
hcfmusp.description.volume10
hcfmusp.origemWOS
hcfmusp.origem.dimensionspub.1169236862
hcfmusp.origem.pubmed38424638
hcfmusp.origem.scopus2-s2.0-85186220830
hcfmusp.origem.wosWOS:001178059300002
hcfmusp.publisher.cityLONDONeng
hcfmusp.publisher.countryENGLANDeng
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