Abstract
Purpose: :
Evaluation of efficacy of atovaquone in the therapy of toxoplasmosis retinochoroiditis.
Methods: :
Twenty six patients with toxoplasmosis retinochoroiditis were treated with atovaquone from 1999 untill 2006 in our department. Diagnosis was based on clinical sings. Atovaquone 750mg two to three times per day and oral steroids were given. Patient histories were serched for location of the leasions, duration to reactivation, visual function after first treatment and adverse events.
Results: :
In total 26 patients, 27 eyes, were treated 16 to 65 years old (32 years mean age). Fiveteen patients were female and 11 male without immunocompromized conditions. Observation duration was 1 to 80 months (18 months mean duration). Diagnosis was proved through treatment answear. No further information was gained by serology in cases where performed. Nine patients had central leasions, five juxtapapillary, 4 temporal branch vessel area and nine peripheral leasions. Twenty one eyes were treated with two times 750mg atovaquone daily and 6 eyes with three times atovaquone daily. No adverse effects due to atovaquone therapy were seen. One hundred to 30mg oral steroids were added depending on patients body weight. In the group with central leasions visual acuity stayed at 0,3 log MAR after first treatment course, 0,5 log MAR in the group with juxtapapillary leasions, 0,15 log MAR in the group with temporal branch vessel leasions and 0,1 log MAR in the group with peripheral leasions. Nine patients showed a retinochoroiditis reactivation. Duration till reactivation ranged from 6 to 70 months (34 months mean duration).
Conclusions: :
Atovaquone is a well tolerated drug to treat effectively toxoplasmosis retinochoroiditis. But in contrast to animal experimantals it couldn’t prevent reactivations.
Keywords: uveitis-clinical/animal model • retinochoroiditis • antibiotics/antifungals/antiparasitics