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.

Duke Scholars

Author Glenn Jay Jaffe Ophthalmology, Vitreoretinal Diseases & Surgery