Ocular Toxoplasmosis Infection Leading to Uveitis or Chorioretinal Lesions: A Systematic Review

Introduction: Toxoplasma gondii (T. gondii) infections affect approximately 30% of the population worldwide. This systematic review of ocular sequelae from toxoplasmosis explores in greater depth the outcomes found in our previous scoping review. Uveitis and ocular lesions can be acute or recurrent following infection and result in long-term and often irreversible effects. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used the Cochrane risk-of-bias tool to evaluate articles for inclusion. Data extraction included the frequency and proportion of participants who developed uveitis or chorioretinal lesions, the type, anatomical locations affected, and disease burden. Results: Utilizing an inclusion criterion that included a physical examination combined with laboratory confirmation, 63 articles from 27 countries spanning a publication period from 2000 to 2023 were included. Most reported outcomes in these articles included uveitis (n = 61), chorioretinal lesions (n = 42), or both (n = 40). Meta analysis results indicate that the proportion of ocular toxoplasmosis (OT) cases resulting in lesions was lower than uveitis, with the highest estimates reported in Asia. Discussion: Uniform diagnostic methodology was only found in articles describing congenital case populations arising from toxoplasmosis monitoring programs. Consistent use of nomenclature, consistent diagnostic testing, and standardized reporting of patient demographics by researchers would greatly aid in understanding the burden of disease experienced.