Intravitreal clindamycin and dexamethasone plus systemic oral anti-toxoplasma versus intravitreal therapy alone in the management of toxoplasma retino-choroiditis

Session Details

Session Title: Free Paper Session 10: Uveitis

Session Date/Time: Friday 08/09/2017 | 11:00-12:30

Paper Time: 11:12

Venue: Room 111

First Author: : A.Mahrous EGYPT

Co Author(s): :    M. Aswad                             

Abstract Details

Purpose:

To compare intravitreal clindamycin and dexamethasone with systemic oral anti-toxoplasma with that of intravitreal treatment only in patients with toxoplasmic retinochoroiditis

Setting:

Alfath eye hospital. zagazig. Egypt

Methods:

30 patients with 30 eyes had active toxoplasma retino-choroiditis were included in this stud. The patients were divided randomly into two groups; group I (15 eyes) had received treatment in the form of intravitreal injection of Clindamycin 1 mg/0.1 ml and Dexamethasone 400 µg/0.1ml plus systemic treatment of Pyrimethamine (25 mg twice daily for 6 weeks), Sulphadiazine (1 g/4 times daily for 6 weeks) and Predinsolone (60 mg/day for 2 weeks then was tapered gradually). Group II (15 eyes) received intravitreal treatment alone without systemic treatment. All patients were followed up at 3, 6 and 12 months. Main outcome measures were resolution of active inflammation, changes in BCVA before and after intervention, changes in central macular thickness measured by OCT, adverse drug reactions during follow-up, and rate of recurrence.

Results:

BCVA was improved from .08±0.17 before treatment to 0.64±0.18 at the end of follow up period in group I and it improved from 1.03±0.15 to 0.69±0.17 in group II with no significant difference (p=0.8). In group I, the mean central macular thickness (CMT) before the treatment was 392.6±33.16 µm and in group II was 397.3±14.6 µm and it improved to be 314.7±4.43 µm and 319.6±7.8 µm after 12 month respectively (p=0.7). Resolution of the acute inflammation was achieved in all cases in both groups with a mean number of injections of 1.4 in group I and 1.7 in group II. The incidence of recurrence within 12 months of follow up was 0 of 15 (0%) in group I and 1 of 15 (6.7%) in group II (p = 0.2).No ocular or systemic adverse events were observed in both groups.

Conclusions:

There is no significant between the treatment by combined intravitral with systemic therapy and the intravitreal treatment only, so the intravitrael injection of clindamycin and dexamethasone can be used in patients with intolerance or contraindication to oral antimicrobial medication

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