CASE-REPORT - INTRAOCULAR MANIFESTATIONS IN PATIENTS WITH CHAGAS-DISEASE (AMERICAN TRYPANOSOMIASIS) - EXAMINATIONS IN PARAGUAY

Background: In Central and South America, Chagas' disease is of great epidemiologic importance. The epidemiologic agent is represented by Tr ypanosoma cruzi, a monocellular parasite, instrumental in human infect ion is the presence of vectors, which are various species of hematopha gous bugs. The eye is one of the most important entrance sites of the parasite, and relatively little information about the relationship bet ween Chagas' disease and eye complications is available. Patients and methods: We examined 79 chagasic patients in order to detect changes i n the retina. As a control group,we examined 48 patients with negative serology within the same age range and from the same regions. For eve ry patient we completed a routine ophthalmologic examination,with insp ection of the retina using direct and indirect ophthalmoscopy. Results :ln most of the chagasic patients, the ocular fundus was unobtrusive; in only 6 out of 79 cases (7.6%) we did observe small parafoveolar ret inal pigment epithelium defects and in 1 case (1.3%) distinct pigment epithelium atrophy of the posterior pole. No comparable findings were observed in the control group. Conclusion: Compared with the examinati on results of the control group, in the patients with intermediate and chronic Chagas' disease we observed an accumulation of retinal pigmen t epithelium defects,which, however, did not cause a significant loss of vision.