Therapy for ocular toxoplasmosis.
PURPOSE: To review current evidence for the treatment of ocular toxoplasmosis (OT). DESIGN: Narrative review and expert recommendations. METHODS: Meta-analysis and selected original articles from the medical literature were reviewed critically. Expert recommendations were analyzed. RESULTS: Numerous observational studies suggest a benefit of short-term antimicrobial therapy for toxoplasmic retinochoroiditis in immunocompetent patients, although its efficacy has not been proven in randomized clinical trials. A randomized clinical trial revealed that intermittent trimethoprim/sulfamethoxazole treatment could decrease the rate of recurrence in high-risk patients. Intravitreal injection of clindamycin and dexamethasone was an acceptable alternative to the classic treatment for OT in a randomized clinical trial. CONCLUSIONS: Opinions about therapy differ and controversy remains about its type, efficacy, and length. Intravitreal therapy may be promising for OT. A recent description of the presence of parasitemia in patients with active and inactive ocular toxoplasmosis raises new questions that need to be explored.
de-la-Torre, A; Stanford, M; Curi, A; Jaffe, GJ; Gomez-Marin, JE
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