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A 26-year-old man with a blind spot in his left eye
Digital Journal of Ophthalmology 2013
Volume 19, Number 3
September 26, 2013
DOI: 10.5693/djo.03.2013.07.001
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Alfred White Jr, MD | USF Eye Institute, University of South Florida
Timothy Saunders, MD | USF Eye Institute, University of South Florida
Peter Reed Pavan, MD | USF Eye Institute, University of South Florida
Treatment
Our patient was treated with a regimen of clindamycin 300 mg 4 times daily, trimethoprim/sulfamethoxazole double strength twice daily for 2 months, and concomitant prednisone 20 mg 4 times daily due to the severity of optic nerve involvement. Over the next 2 months, the prednisone was tapered to 5 mg daily. After 2 months of follow-up, he showed resolution of disc edema, macular edema, and extramacular serous retinal detachment but only mild improvement of the original scotoma. This response was consistent with the higher likelihood of permanent visual field changes in toxoplasmic neuroretinitis.(2) Ultimately, the patient was lost to follow-up, but when he was contacted 2 years after the initial episode, he reported no recurrence of symptoms.
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