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Carlos A Abdala, Monica P Muñoz; INTRAVITREAL CLINDAMYCIN AND DEXAMETHASONE FOR OCULAR TOXOPLASMOSIS. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2849.
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To report the anatomic and functional outcomes of intravitreal clindamycin and dexamethasone for the treatment of Toxoplasmic Retinochoroiditis (TRC), in patients with intolerance, contraindications or lack of response to traditional systemic therapy.
Non-comparative, retrospective, case series study. 28 consecutive patients with TRC with lesions in zone I or with TRC unresponsive to systemic (oral) conventional treatment were treated with Intravitreal Clindamycin (1 mg/0.1 ml) and Dexamethasone (0.4 mg/0.1 ml). The mean visual acuity (VA) before treatment was 20/100 (CF 50 cm - 20/70). The localization of the lesions was macular (18 eyes) and close to optic nerve head (10 eyes). 12 eyes had received previous systemic treatment.
22 of 28 patients (78,5%) improved VA of which 100% had juxtapapilar, 75% juxtafoveal and 50% foveal lesions. 6 of 28 patients (21,4%) did not improve. 13/15 patients (86.6%) who requiered a single dose of intravitreal clindamycin and Dexamethasone improved VA and TRC regressed. 13 patients (46,4%) required a 2nd dose of clindamycin and dexamethasone indicated for persistent vitreitis or reactivation of lesions. 9 patients improved VA and had TRC regression. 3/28 patients (10,7%) required a 3rd dose of intravitreal injection with an improvement of VA and TRC regression in 2 patients. Ocular adverse events were ocular hypertension in 7 eyes (25%), whitening of inner retina in 1 eye (3,5%) and epiretinal membrane in 2 eyes (7,1%).
The use of a combination of Clindamycin and Dexamethasone for Intravitreal administration is a safe and acceptable alternative with good functional and anatomic outcomes for the treatment of Toxoplasmic Retinochoroiditis affecting foveal, juxtafoveal or juxtapapilar areas in the retina.
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