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Mariana Lucila Urdapilleta, Miguel Pedroza-Seres, Ethel Beatriz Guinto Arcos, Rosalva Bobadilla; Comparison of Two Treatments in Active Ocular Toxoplasmosis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1865. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the clinical and visual results of two different treatment modalities in patients with active ocular toxoplasmosis
We reviewed the medical records of patients with the diagnosis of active ocular toxoplasmosis in the period of 2007 to 2014 in the Ophthalmologic Institute Conde de Valenciana. Initial visual acuity, final visual acuity, gender, age, affected eye, anterior and posterior cellularity, and site of active retinochoroidal lesion were analyzed. Patients were treated with a transeptal injection (paraocular) with clindamycin plus betamethasone or with transeptal injection plus oral antibiotics (clindamycin or sulfamethoxazole-trimethoprim, or pyrimethamine). For statistic analysis we used Mann-Whitney U’s test for non-parametric tests
We included 82 patients with active toxoplasmosis. 34 (41.4%) patients were in the paraocular group, and 48 (58.6%) in the paraocular plus oral antibiotic study group. The main age was 28.7 years, the most common gender was female (1.2:1), the most common affected eye was the right one (1.1;1). The average cellularity in the anterior chamber was of one cross, and in the posterior chamber was of two crosses. Panuveitis was the most common type of uveitis presentation (51%).For patients treated with paraocular only, the average time of disease inactivation was 2.4 months, the number of paraocular treatments required to control active inflammation were 2.5 injections, the average improvement in visual acuity was 3.4 lines with a final visual acuity of 0.42 with LogMAR. In the group of oral treatment plus paraocular injection, the average time of disease inactivation was 3.2 months, the paraocular treatment needed were 2.8 injections, with 4.2 sight lines of improvement and a final visual acuity of 0.44 with LogMAR.There was no statistically significant difference between the improved sight lines in both groups (p 0.7669)
Conclusion: Transeptal administration of clindamycin plus betamethasone without oral treatment represents a safe and effective treatment in active ocular toxoplasmosis. With this regimen, secondary systemic effects of oral treatment are diminished. Among the groups, final visual acuity was no statistically significant. Further studies are required to follow both groups of patients to observe the relapses of the disease to evaluate control in long term in order to decide which one of this regimen is more beneficial.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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