Introduction:

Ocular toxoplasmosis with foveal involvement is a rare entity that can seriously compromise visual acuity. We present a case of primary infection diagnosed in a young patient and treated with intravitreal therapy as an alternative approach for vision preservation.

Objective:

To describe the clinical and visual evolution of a patient with active ocular toxoplasmosis and foveal involvement treated with intravitreal clindamycin and dexamethasone.

Material and Methods:

Retrospective observational study in the form of a clinical case report, with short-term follow-up. An 18-year-old male presented with decreased visual acuity in the right eye for the past three days, preceded by the appearance of black floaters. He was evaluated at the Retina Service of the Department of Ophthalmology of the Fundación Banco de Ojos “Fernando Oca del Valle,” an external site of the National University of Asunción, in Asunción, Paraguay. Initial examination revealed anterior chamber reaction, an active foveal chorioretinitis lesion on fundus examination, and visual acuity of counting fingers at one meter. Primary infection was confirmed through specific serology. Three cycles of intravitreal clindamycin (1 mg/0.1 mL) and dexamethasone (400 μg/0.1 mL) were administered at fifteen-day intervals during a three-month follow-up period.

Results:

After three months of follow-up with intravitreal treatment, the patient showed partial visual improvement in the right eye, reaching a visual acuity of 20/150. A relative central scotoma persisted. Fundus examination revealed a well-defined foveal scar without signs of residual inflammatory activity.

Discussion:

This case highlights the role of intravitreal therapy as an effective option to manage active ocular infections with severe visual compromise, minimizing permanent sequelae.

Conclusion:

Early intervention with intravitreal therapy is an effective alternative in selected cases of active ocular toxoplasmosis with foveal involvement.

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