title: Local treatment of toxoplasmic retinochoroiditis with intravitreal clindamycin and dexamethasone.
abstract: To report the clinical outcomes of local treatment of toxoplasmic retinochoroiditis (TRC) with intravitreal injections of clindamycin and dexamethasone.
  
  
  
  
  
  
  
  16 eyes (16 patients) with active TRC sparing the macula and juxtapapillary area treated with intravitreal injections of clindamycin (1 mg) and dexamethasone (1 mg) without concomitant systemic antitoxoplasmic or anti-inflammatory therapy. Measured parameters: Best-corrected visual acuity (BCVA) was measured by an Early Treatment Diabetic Retinopathy Study (ETDRS) chart. BCVA and clinical characteristics of retinochoroiditis were assessed at baseline and at 1, 3, 6, and 12 months.
  
  
  
  Resolution of retinochoroiditis and changes in BCVA.
  
  
  
  Control of TRC was achieved in all cases with a mean interval of 2.48 ± 1.03 weeks (2-6 weeks). A single injection of intravitreal clindamycin and dexamethasone was performed in 12 patients, and four patients required two intravitreal injections, during the follow-up period. Fourteen eyes (87.5%) improved ≥ 2 ETDRS lines of BCVA, of two or more Early Treatment Diabetic Retinopathy Study lines, BCVA remained stable in two eyes (12.5%), and no patient had decreased BCVA at the end of the follow-up period. No ocular or systemic adverse events were observed.
  
  
  
  Local treatment with intravitreal injections of clindamycin and dexamethasone without concomitant systemic therapy was associated with resolution of TRC in patients without macular or juxtapapillary involvement. Intravitreal clindamycin and dexamethasone may represent a viable treatment option in patients with allergies or inadequate responses to oral medications.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Yuslay Fernández
authors.initials: YF
authors.lastname: Zamora
authors.affiliation: Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Tiago
authors.initials: T
authors.lastname: Arantes
authors.affiliation: Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Frederico Augusto
authors.initials: FA
authors.lastname: Reis
authors.affiliation: Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Claudio Renato
authors.initials: CR
authors.lastname: Garcia
authors.affiliation: Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Janaína Jamile Ferreira
authors.initials: JJ
authors.lastname: Saraceno
authors.affiliation: Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Rubens
authors.initials: R
authors.lastname: Belfort
authors.affiliation: Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Cristina
authors.initials: C
authors.lastname: Muccioli
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002825:Chorioretinitis / Q000188:drug therapy* / Q000503:physiopathology; D002981:Clindamycin / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D014126:Toxoplasmosis, Ocular / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D002981:Clindamycin; D003907:Dexamethasone