Corticosteroids for ocular toxoplasmosis

Infestation with Toxoplasma gondii, a parasite, occurs in different body tissues including the eye. It occurs in people throughout the world. The main animal that hosts the organism is the cat, but its principal source is unknown. The parasite is transmitted through ingestion of under-cooked meat and food or drinking water contaminated with cat feces. The disease in the eye has a wide spectrum of presentation, ranging from no symptoms to severe visual impairment. The usual mode of treatment involves administration of anti-parasitic agents. Sometimes corticosteroids are used to supplement anti-parasitic agents with the goal of decreasing the intensity of tissue damage. In this review, we examined evidence on whether using corticosteroids in addition to anti-parasitic agents is more effective than anti-parasitic agents alone. We searched multiple electronic databases for trials evaluating the use of corticosteroids in the management of toxoplasma infestation of the eye. We found no randomized controlled trials to support the use of corticosteroids in addition to anti-parasitic agents for toxoplasma infestation of the eye. Further research is needed and should focus on generating evidence to support regular use of corticosteroids in the management of patients with ocular toxoplasmosis, the dosage, duration of use and time of initiation during the course of anti-parasitic treatment. Outcomes relevant to patients, such as time to recovery from signs and symptoms of visual impairment, should be assessed in future trials addressing this question.