Intravitreal Clindamycin as First-Line Therapy for Toxoplasmic Retinochoroiditis: A Case Series

To report a case series of four ocular toxoplasmosis patients who received intravitreal clindamycin as first-line treatment.

Retrospective interventional case series.

Four (two females and two males) patients were diagnosed with active primary toxoplasmic retinochoroiditis based on their clinical presentation. All patients received intravitreal clindamycin 1mg/0.1mL as first-line therapy (two injections with 1-week interval). Oral corticosteroid 1mg/kg/day was also given in a tapering fashion over 4-6 weeks. A remarkable response was seen in all cases with improved visual acuity, sharpening of the lesion borders, and resolution of inflammation within 4-6 weeks. No recurrence or reactivation was noted until 2 years follow-up.

Intravitreal clindamycin, combined with oral corticosteroids, can be considered an effective and safe first-line therapy for active toxoplasmic retinochoroiditis. It provides the patient a more convenience, safer systemic side effect profile, increased availability, and fewer follow-up visits and hematologic investigations.