[Six-month real-world outcomes of intravitreal clindamycin for ocular toxoplasmosis]

Objective: To evaluate in a real-world setting an intravitreal clindamycin treatment protocol for ocular toxoplasmosis.

Methods: This was a single-center, retrospective review with a 6-month follow-up. Our protocol proposed an IVT of clindamycin as first-line treatment, and management was chosen according to the patient's status (past medical history of ocular toxoplasmosis or not). We evaluated the gain in best corrected visual acuity (BCVA) at 6months, the therapeutic burden and anatomical outcomes.

Results: The study included 38 eyes of 38 patients. The 6-month follow-up was reached for 23 patients. In the whole cohort, 6 patients experienced one recurrence, and one patient had two recurrences (mean time to recurrence 65±36days), for a total number of 46 occurrences. BCVA gain was 0.24±0.49 logMAR (P-value 0.023). Cicatrization of the chorioretinal lesion was obtained with a mean number of 1.3 (62/46) IVT of clindamycin (1 to 4 IVTs per patient per episode) and a mean time between 2 IVT for the same occurrence of 15.9±8.5days. The percentage of occurrences resolved with a single IVT was 67% (31/46). Oral corticosteroid therapy was started in 26 patients (68%). We demonstrated no adverse effects of IVT, except for one patient who developed a retinal detachment.

Conclusion: Our study shows the efficacy and tolerance of our intravitreal treatment protocol with clindamycin for ocular toxoplasmosis.