[Efficacy of specific chemotherapy in the prevention of recurrences of toxoplasmic chorioretinitis during the 4 years following the treatment]

Abstract

The effectiveness of a curative or preventive therapy in toxoplasmic retinochoroiditis is difficult to evaluate clinically. The goal of the present paper was to study the recurrence rate of ocular toxoplasmosis during a four years period following a Pyrimethamine-sulfadiazine therapy. Some case had received previous therapy (systemic steroids alone or in combination with Spiramycin) which had not effected a lasting cure. In this series of 54 patients diagnosed as having active toxoplasmosis chorioretinitis, the combination of Pyrimethamine and Sulfadiazine seems statistically more effective than other reported treatments. The recurrence rate in a four years follow up study was 40 percent. The benefit of the therapy is more obvious in severe toxoplasmosis uveitis (with severe vitreous reaction, high recurrence rate, macular lesions). The treatment was less effective when indicated after an ineffective previous therapy. The dosage and the duration of the therapy must be adapted to each case. No complication was experienced during the treatment. In order to prevent recurrent toxoplasmosis uveitis Pyrimethamine-Sulfadiazine therapy appears to be the only effective synergistic therapy.