Hosseini Seyedeh Maryam, Abrishami Mojtaba, Mehdi Zadeh Mehran
Retina Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran.
Retina Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran ; Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Iran Red Crescent Med J. 2014 Nov 17;16(11):e15428. doi: 10.5812/ircmj.15428. eCollection 2014 Nov.
The current study aimed to report a case of toxoplasma chorioretinitis resistant to standard treatments that dramatically responded to intravitreal clindamycin injection.
A 23-year-old woman with the diagnosis of ocular toxoplasmosis in the left eye was initially treated by oral pyrimethamine, sulfadiazine, azithromycin and oral prednisolone. Since the treatment was unsuccessful intravitreal clindamycin (1 mg/ 0.1 mL) was injected. Responding dramatically, visual acuity improved from hand motion to 20/60 and 20/20, after seven days and six weeks, respectively. Anterior chamber and vitreous reactions were resolved.
Intravitreal injection of clindamycin may be an acceptable alternative to the classic treatment in cases with refractory ocular toxoplasmosis. It may offer the patient more convenience, a safer systemic side effect profile, greater availability, and fewer follow-up visits and hematologic evaluations. Moreover, since it responds dramatically, it would be helpful in cases with involvement of macula or closeness to the optic nerve.
本研究旨在报告一例对标准治疗耐药的弓形虫性脉络膜视网膜炎病例，该病例对玻璃体内注射克林霉素有显著反应。
一名23岁诊断为左眼眼弓形虫病的女性患者，最初接受口服乙胺嘧啶、磺胺嘧啶、阿奇霉素及口服泼尼松龙治疗。因治疗无效，遂行玻璃体内注射克林霉素（1毫克/0.1毫升）。注射后反应显著，视力分别在7天和6周后从手动提高到20/60和20/20。前房及玻璃体反应消退。
对于难治性眼弓形虫病病例，玻璃体内注射克林霉素可能是经典治疗的一种可接受的替代方法。它可为患者提供更多便利、更安全的全身副作用谱、更高的可及性，以及更少的随访次数和血液学评估。此外，由于其反应显著，对于黄斑受累或靠近视神经的病例会有帮助。
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