Author: Kubra Ozdemir Yalcinsoy (Turkey)
Co-authors: Yasemin Ozdamar Erol, Pinar Cakar Ozdal
Purpose
To present the patients with ocular toxoplasmosis using intravitreal clindamycin in addition to systemic therapy or as first-line therapy.
Setting/Venue
University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey.
Methods
Data of seven patients were collected retrospectively. Ocular examination findings and treatment approach were evaluated.
Results
Seven eyes of 7 patients with active ocular toxoplasmic retinochoroiditis were evaluated (four female and three male). Fundus examination showed that lesions of retinochoroiditis were localized near to the optic disc in 3 eyes (43%), in the macula in 2 eyes (29%), in the peripheral retina in 1 eye (14%), and there was neuroretinitis and optic disc involvement in 1 eye (14%). All patients received an average of 1.8 (1-3) intravitreal clindamycin injections (0.1mg/0.1mL, at 1-week interval). In systemic treatment, trimethoprim-sulfamethoxazole (800/160 mg*2 /day), azithromycin (500 mg / day), and methylprednisolone (starting at 0.5-1 mg / kg / day, in decreasing doses) combination were given to 3 patients (43%). Systemic treatment was not given to 2 patients (29%) with sulfamide allergy and 2 patients (29%) who were breastfeeding. Also, 3 of these patients (43%) received subtenone betamethasone and 1 patients (14%) oral methylprednisolone. With the treatments, regression in the lesions, decrease in inflammation and improve in visual acuity were achieved in all patients.
Conlusions
Ocular toxoplasmosis is a vision-threatening severe disease, especially when there is optic disc and macular involvement. Intravitreal clindamycin injection can be used as the first-line treatment, when classical therapy is contraindicated, or in addition to systemic therapy in severe cases. Intravitreal clindamycin may be preferred in the treatment ocular toxoplasmosis because of its less systemic side effects profile, high intraocular drug concentration and effective clinical results.
Financial Disclosure
No financial support or financial conflict of interest.
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