Clinical Characteristics Associated With Complications and Poor Visual Outcomes in Ocular Toxoplasmosis: Analysis of 853 Patients

PURPOSE: To describe the clinical characteristics of ocular toxoplasmosis (OT) in Colombia and identify factors associated with ocular complications and poor visual outcomes. DESIGN: Multicenter cross-sectional study. METHODS: Demographic and clinical characteristics—including disease course, uveitis location (according to the Standardization of Uveitis Nomenclature), type of inflammation (presumed granulomatous vs nongranulomatous), ocular complications (cataract, glaucoma, macular edema, retinal detachment, vitreous hemorrhage, epiretinal membrane, and band keratopathy), and visual outcomes—were collected from patients with OT across seven ophthalmological centers in Colombia. A subgroup analysis included patients with documented lesion characteristics. Logistic regression, adjusted for age and sex, assessed factors associated with ocular complications (any of the complications above), moderate-to-severe vision impairment (BCVA <20/60 to >20/400 in the better-seeing eye), and blindness (BCVA ≤20/400 in the better-seeing eye). RESULTS: 853 OT patients (431 females, 422 males) were included, with a mean age of 38 ± 17.9 years. OT predominantly manifested as acute (57%), unilateral (79%), and nongranulomatous uveitis (78%). Sixty percent (512) had a final BCVA >20/60. Factors associated with ocular complications included age >50 (OR = 4.75; P < .001), retinochoroiditis with vitritis/AC inflammation (OR = 2.85; P < .001), presumed granulomatous uveitis (OR = 2.04; P < .001), persistent disease or early recurrences (sooner than 3 months) (OR = 3.24; P < .001), and recurrences first occurring after 3 months (OR = 1.79; P = .009). Blindness was linked to age <16 (OR = 1.94; P = .025), >50 (OR = 1.74; P = .001), bilateral involvement (OR = 1.53; P = .017), and zone 1 lesions (OR = 8.25; P = .015). CONCLUSION: OT in Colombia shows worse outcomes compared to other regions. Extreme ages, bilateral involvement, retinochoroiditis with vitritis/AC inflammation, and zone 1 lesions are major risk factors for complications and poor visual outcomes.