Prise en charge de la toxoplasmose oculaire en France : résultats d'une étude Delphi modifiée/thèse présentée pour le diplôme d'État de docteur en médecine, diplôme d'État, mention DES ophtalmologie
Langue Français
Langue Français
Auteur(s) : Schaeffer Marion
Composante : MEDECINE
Date de création : 30-06-2021
Description : Médecine (ophtalmologie), Objective: To evaluate diagnostic and therapeutic practices and then establish a consensus on the management of ocular toxoplasmosis in France thanks to a Delphi study. Materials and methods: 23 French experts in ocular toxoplasmosis were invited to respond to a modified Delphi study conducted online, in the form of two questionnaires, to try to establish a consensus on the diagnosis and management of this pathology. The threshold for identical responses to reach consensus has been set at 70%. Results: The replies of 19 experts out of the 23 selected were obtained on the first questionnaire and from 16 experts on the second. The main elements that are agreed by experts are to treat patients with a decrease in visual acuity or an infectious focus at the posterior pole, the prescription of first-line treatment with pyrimethamine-azithromycin, the use of corticosteroid therapy after a period of 24 to 48 hours, the prophylaxis of frequent recurrences (more than 2 episodes per year) with trimethoprim-sulfamethoxazole as well as the implementation of prophylactic treatment of recurrences in immunocompromised patients. On the other hand, no consensus emerges for the examinations to be carried out for the etiological diagnosis (anterior chamber puncture, fluorescein angiography, serology ...), for second-line treatments (in case of failure of first-line treatment) nor for the treatment of peripheral foci. Conclusion: This study lays the foundations for possible randomized scientific studies to be conducted to clarify the management of ocular toxoplasmosis, on the one hand to confirm the clinical habits that are consensual and on the other hand to guide practices for which no formal consensus is demonstrated
Mots-clés libres : Toxoplasmose oculaire -- Dissertation universitaire, Ophtalmie -- Dissertation universitaire, Uvéite, Delphi, Méthode, 617.7
Couverture : FR
Composante : MEDECINE
Date de création : 30-06-2021
Description : Médecine (ophtalmologie), Objective: To evaluate diagnostic and therapeutic practices and then establish a consensus on the management of ocular toxoplasmosis in France thanks to a Delphi study. Materials and methods: 23 French experts in ocular toxoplasmosis were invited to respond to a modified Delphi study conducted online, in the form of two questionnaires, to try to establish a consensus on the diagnosis and management of this pathology. The threshold for identical responses to reach consensus has been set at 70%. Results: The replies of 19 experts out of the 23 selected were obtained on the first questionnaire and from 16 experts on the second. The main elements that are agreed by experts are to treat patients with a decrease in visual acuity or an infectious focus at the posterior pole, the prescription of first-line treatment with pyrimethamine-azithromycin, the use of corticosteroid therapy after a period of 24 to 48 hours, the prophylaxis of frequent recurrences (more than 2 episodes per year) with trimethoprim-sulfamethoxazole as well as the implementation of prophylactic treatment of recurrences in immunocompromised patients. On the other hand, no consensus emerges for the examinations to be carried out for the etiological diagnosis (anterior chamber puncture, fluorescein angiography, serology ...), for second-line treatments (in case of failure of first-line treatment) nor for the treatment of peripheral foci. Conclusion: This study lays the foundations for possible randomized scientific studies to be conducted to clarify the management of ocular toxoplasmosis, on the one hand to confirm the clinical habits that are consensual and on the other hand to guide practices for which no formal consensus is demonstrated
Mots-clés libres : Toxoplasmose oculaire -- Dissertation universitaire, Ophtalmie -- Dissertation universitaire, Uvéite, Delphi, Méthode, 617.7
Couverture : FR
Type : Thèse d’exercice, ressource électronique
Source(s) :
Source(s) :
- http://www.sudoc.fr/258032162
Entrepôt d'origine :
Identifiant : ecrin-ori-319940
Type de ressource : Ressource documentaire
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Identifiant : ecrin-ori-319940
Type de ressource : Ressource documentaire