Does atovaquone prolong the disease-free interval of toxoplasmic retinochoroiditis?
BACKGROUND
To evaluate the efficacy of suppressing a recurrence of Toxoplasma retinochoroiditis after treatment with atovaquone.


METHODS
Retrospective, nonrandomized, clinical trial. Forty-one immunocompetent patients were treated for Toxoplasma retinochoroiditis with atovaquone between 1999 and 2006. The diagnosis was based on clinical signs alone. Atovaquone was given 750 mg two to three times daily together with oral steroids. Lesion location, time interval until recurrence, visual function, and adverse events were recorded.


RESULTS
Forty-two eyes of 41 patients were treated with atovaquone for Toxoplasma retinochoroiditis. Side-effects were usually mild and only one patient stopped therapy with atovaquone because of nausea. Reactivation of retinochoroiditis occurred in 18 patients (44%) during a time interval of 3-70 months.


CONCLUSIONS
The therapy of Toxoplasma retinochoroiditis with atovaquone is well tolerated. Our data suggests that therapy with atovaquone has the potential to prolong the time to recurrence of Toxoplasma retinochoroiditis. A prospective randomized comparative long-term clinical trial would be necessary to confirm our data.
Winterhalter
Sibylle
S
Department of Ophthalmology, University Hospital Düsseldorf, Düsseldorf, Germany. billewin@gmx.de
Severing
Katja
K
Stammen
Johannes
J
Maier
Anna Karina
AK
Godehardt
Erhard
E
Joussen
Antonia Maria
AM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000981:Antiprotozoal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D053626:Atovaquone / Q000009:adverse effects / Q000627:therapeutic use*; D002825:Chorioretinitis / Q000188:drug therapy* / Q000469:parasitology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D014126:Toxoplasmosis, Ocular / Q000188:drug therapy* / Q000469:parasitology; D014792:Visual Acuity; D055815:Young Adult
D000981:Antiprotozoal Agents; D053626:Atovaquone