Toxoplasmosis-Associated Neovascular Lesions Treated Successfully With Ranibizumab and Antiparasitic Therapy

Intravitreal ranibizumab for choroidal neovascularization related to traumatic Bruch’s membrane rupture

“…It has been successfully used in off-label treatment of CNV in other retinal diseases in which VEGF is upregulated [4][5][6][7][8]: diabetic retinopathy, pathologic myopia, angioid streaks and central venous occlusion. Treatment for traumatic CNV has been recently described with anti-VEGF [8], but with a different drug, bevacizumab.…”

Toxoplasmosis

“…In this instance, central visual acuity may be permanently impaired despite the absence of central lesions or involvement of the optic nerve. Treatment with an antibody to Veg F can result in resolution of choroidal neovascular membranes [410].…”

Management of Congenital Toxoplasmosis

“…Alternative medicines for patients with atopy or severe intolerance of sulfonamides have included Pyrimethamine and Leucovorin with clindamycin or azithromycin or atovaquone, with standard dosages as recommended according to weight. In the unusual circumstance that medicines cannot be administered orally or by intraintestinal tube feeding, trimethoprim, sulfamethoxazole, and clindamycin have been administered intravenously e Corticosteroids should be used only in conjunction with Pyrimethamine, Sulfadiazine, and Leucovorin treatment and should be continued until signs of inflammation (high CSF protein, C1 g/dL) or active chorioretinitis that threatens vision have subsided, ususally *10-14 days; dosage can then be tapered and the steroids discontinued f Image figure from: Benevento et al [173], with permission Curr Pediatr Rep (2014) [206,207]. b Administration of these medicines in management of congenital T. gondii infection in the first year of life.…”

“…Adapted with permission from McLeod et al [206,207] it is reasonable to determine whether other family members were also acutely infected at the time a pregnant woman has acquired infection or a congenitally infected baby is born. Because retinal disease may occur in up to 10 % of mothers of infected babies and may occur in family members who could benefit from treatment, it may be prudent to also test other family members of infected babies [172,173].…”