Intravitreal Clindamycin in the Treatment of Unresponsive Zone One Toxoplasmic Chorioretinitis: A Case Report

INTRODUCTION: The current study aimed to report a case of toxoplasma chorioretinitis resistant to standard treatments that dramatically responded to intravitreal clindamycin injection. CASE PRESENTATION: 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. CONCLUSIONS: 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.