A COMBINATION REGIMEN OF INTRAVITREAL CLINDAMYCIN WITH DEXAMETHASONE, SYSTEMIC CO-TRIMOXAZOLE AND STEROIDS FOR MACULAR TOXOPLASMA RETINOCHOROIDITIS IN IMMUNOCOMPETENT CASES

Abstract

Purpose: To study the role of intravitreal clindamycin with dexamethasone as an adjuvant to systemic co-trimoxazole and steroids in macular Toxoplasma retinochoroiditis.

Methods: Retrospective study of Toxoplasma retinochoroiditis cases from January 2014 to December 2021 treated with a combination of oral and intravitreal therapy in immunocompetent patients.

Results: Thirty-nine eyes of 39 patients were included in this study after meeting the inclusion criteria with the mean age of presentation being 25.25 years (±9.30; range 4-52 years). Male preponderance with 61.53% of male patients (n = 24) and 38.47% of female patients (n = 15) was observed. Active retinitis was unilateral in all eyes (20 right eyes; 19 left eyes). Five lines of improvement in visual acuity on Early Treatment Diabetic Retinopathy Study (ETDRS) chart were noted at final visit. The location of retinitis was either foveal (n = 24) or extrafoveal (n = 15). The mean size of retinitis was 1.24 ± 0.70-disc diameter. The mean number of injections given was 1.79 with a mean interval of 1.39 weeks.

Conclusion: Intravitreal clindamycin with dexamethasone when used as an adjunct to systemic therapy showed resolution of retinitis in all cases with visual improvement.

Keywords: clindamycin; co-trimoxazole; dexamethasone; fovea; intravitreal injections; macula; ocular toxoplasmosis; parafovea; toxoplasmic retinitis; toxoplasmic retinochoroiditis.