Injection intravitréenne de clindamycine dans le traitement des rétinochoroïdites toxoplasmiques : à propos de 9 cas dans le service d’ophtalmologie du CHU de Bordeaux

Abstract

Toxoplasma retinochoroiditis (TRC) is the main cause of posterior uveitis in immunocompetent patients. Several studies have shown safety and efficacy of treatment with intravitreal clindamycin injection in patients with contraindications, inadequate response or side effects with classic oral therapy. The goal of this study is to describe anatomic and functional results of local treatment with intravitreal clindamycin injection. We performed an observational, retrospective, single-center study in the ophthalmology service of Bordeaux university medical center between December 2017 and January 2020 on management of toxoplasma retinochoroiditis by intravitreal clindamycin injection. We analyzed the efficacy of this treatment on improvement in visual acuity, decrease in size of the retinal lesion and decrease in macular thickness. A total of 10 eyes of 9 patients were injected. Only a single injection was required in 9 of the 10 cases. Injections demonstrated improvement in the 3 study criteria; visual acuity went from a mean of 1 LogMAR (1.07±0.77) pre-injection to 0.4 LogMAR (0.43±0.53) at 6 months, lesion size decreased by 51%, and macular thickness decreased by 78μm over the follow-up period. Intravitreal clindamycin injections are safe and effective for the treatment of TRC. They offer an alternative in patients with allergies, side effects or inadequate response to classic oral therapy.