Clinical Outcomes in Toxoplasmic Retinochoroiditis: Comparing Intravitreal Clindamycin with and Without Adjunctive...

The goal was to compare the clinical characteristics and visual outcomes of patients treated with intravitreal clindamycin with and without adjunctive steroids for vision-threatening toxoplasmic retinochoroiditis.

A single-center retrospective cohort study of all toxoplasmic retinochoroiditis cases from January 1, 2013 to December 31, 2024 treated with intravitreal clindamycin was reviewed. Patients with vision-threatening disease and ≥3 months of follow-up data were included. Data collected included best-corrected visual acuity (BCVA), retinitis zone, aqueous and/or vitreous tap polymerase chain reaction results, number and type of intravitreal injections and systemic medications, complications and recurrence rates.

A total of 21 eyes from 20 patients were included. All patients were placed on oral antibiotic treatment. About 28.6% of eyes (6/21) received oral steroids, 28.6% of eyes (6/21) received adjunctive intravitreal dexamethasone injections, 23.8% of eyes (5/21) received both, and four eyes did not receive any adjunctive steroids. A mean of 3.2 intravitreal clindamycin injections were administered from initial to last follow-up visit. There was a statistically significant improvement of 0.54 logMAR in visual acuity regardless of treatment regimen (p < 0.008). Adjunctive corticosteroid exposure did not have a statistically significant difference in BCVA in this small retrospective cohort (p = 0.47).

Patients with toxoplasmic retinochoroiditis treated with intravitreal clindamycin had significantly improved BCVA. The addition of intravitreal or oral steroids did not have a statistically significant difference on vision or complication rates in this small retrospective cohort. No cases of injection-related endophthalmitis or lens injury were observed, but the small sample size limits conclusions regarding safety.