First Author: B.Stoica SPAIN
Co Author(s): E. Corredera Salinero I. Gabarron Hermosilla N. Toledano Fernandez
Purpose:
To present a case of ocular toxoplasmosis in a pregnant woman successfully treated with three injections of intravitreal clindamycin and dexamethasone. We evaluate the advantages over systemic treatment.
Setting:
Hospital Universitario de Fuenlabrada
Methods:
A 36 year-old patient, 3 months pregnant, presents to the emergency room with decreased visual acuity, red eye and photophobia. The eye exam revealed significant anterior uveitis, normal intraocular pressure, significant vitritis and a chorioretinal focus outside the arcades (" headlight in the fog" ). She was treated with 3 intravitreal injections of clindamycin (1 mg in 0.1 ml) and dexamethasone (400microg in 0.1 ml), 1 injection every 2 weeks. Topical dexamethasone and cycloplegic eye drops were used for the anterior uveitis.
Results:
The patient had a significant visual improvement 3 days after the first injection, continued to improve with the next injections, reaching a final visual acuity of 0.7, which she maintains in the present. The vitritis disappeared and the chorioretinal focus decreased, leaving only a pigmented scar.
Conclusions:
Ocular toxoplasmosis is the most common cause of infectious posterior uveitis and can cause significant visual loss. For the classical ocular involvement we recommend the intravitreal injections rather than administering a systemic antibiotic therapy. Treatment with two or three injections has many advantages compared to the classic therapy with 10 pills a day: better compliance, availability, fewer visits, no systemic side effects (blood disorders, pregnant women, children). FINANCIAL DISCLOSURE?: No
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