Ocular toxoplasmosis: A review of current treatment options Review article

Abstract

Ocular toxoplasmosis (OT), a global health concern due to the protozoan T. gondii, disproportionately affects immunocompromised individuals, causing severe eye infections and potential vision loss. This review aims to evaluate current treatment options, highlighting challenges in managing both congenital and acquired forms of the infection. Our analysis synthesizes findings from 21 recent studies and a key specialty textbook, selected through systematic searches on databases including PubMed and ScienceDirect, focusing on treatments developed since 2018 to ensure relevance in the field of OT management. While diagnosis relies heavily on clinical assessments, advanced imaging like optical coherence tomography and fluorescein angiography, as well as serological and PCR testing, have improved detection. Treatment primarily involves antiparasitic and antibacterial drugs, yet standard protocols, such as pyrimethamine and sulfadiazine combinations, often fail due to severe side effects and high recurrence rates. The emergence of drug-resistant strains complicates therapy, underscoring the necessity for novel treatment approaches. Recent advancements suggest potential in mitochondrial inhibitors and histone deacetylase inhibitors, yet further research is essential to minimize toxicity and enhance specificity. OT management is hindered by the complexity of its clinical presentation and the suboptimal efficacy of traditional treatments. Personalized treatment strategies, considering patient history and local drug availability, are critical for improving outcomes in those afflicted by this debilitating infection.