Successful treatment of toxoplasmosis-associated choroidal neovascular lesions with bevacizumab and antiparasitic therapy.
OBJECTIVE
To report the effects of oral trimethoprim/sulfamethoxazole and intravitreal bevacizumab injection in the treatment of ocular toxoplasmosis-associated choroidal neovascular lesions (CNV).


METHODS
This was a noncomparative, nonrandomized, consecutive case series. All eyes with ocular toxoplasmosis-associated CNV received one intravitreal bevacizumab injection under the coverage of oral trimethoprim/sulfamethoxazole. The changes in best-corrected visual acuity were recorded. Serial fundus photography, fluorescein angiography, optical coherence tomography, and indocyanine green angiography were performed to measure the treatment efficacy.


RESULTS
Three eyes of two patients with a history of ocular toxoplasmosis had active CNV demonstrated by fluorescein angiography and optical coherence tomography. Each was treated with oral trimethoprim/sulfamethoxazole and one intravitreal bevacizumab injection. Best-corrected visual acuity, fundus photographs, fluorescein angiography, optical coherence tomography, and indocyanine green angiography all showed favorable results. No ocular or systemic complications were noted. In all three eyes, the CNV subsided and vision improved.


CONCLUSIONS
Oral trimethoprim/sulfamethoxazole is an effective and less expensive antibiotic against Toxoplasma gondii. Intravitreal bevacizumab injection appears to be a well-tolerated treatment for toxoplasmosis-associated CNV and has the potential as an adjuvant therapy to improve final vision. More cases and further studies are required.
From the *Department of Ophthalmology, Changhua Christian Hospital, Changhua County, Taiwan; †Department of Optometry, Chung Hwa University of Medical Technology, Tainan County, Taiwan; and ‡School of Medicine, Chung Shan Medical University, Taichung City, Taiwan; and §Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Chun-Ju
CJ
Lin
San-Ni
SN
Chen
Jiunn-Feng
JF
Hwang
Pei-Shin
PS
Hu