A systematic review of the clinical course, diagnosis, and management of ocular toxoplasmosis in immunocompromised patients, synthesizing 276 cases from 109 published reports alongside epidemiological and immunological studies.
Visual outcomes in immunocompromised patients with ocular toxoplasmosis are frequently poor; atypical presentations are common, and in over half of reported cases the diagnosis was initially missed.
Data are compiled from case reports and small series rather than prospective cohorts, introducing selection bias; the heterogeneity of immunocompromising conditions limits generalizability; and reliance on published literature may underrepresent mild or rapidly fatal cases.
Clinicians should maintain a high index of suspicion for ocular toxoplasmosis in any immunocompromised patient with posterior uveitis, even when the presentation is atypical, as delayed diagnosis is common and contributes to poor visual outcomes. Early diagnostic workup and prompt management are essential to limit ocular and systemic complications.
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