Controversy and consensus on the management of ocular toxoplasmosis: A joint statement by the Asia-Pacific Society of Ocular Inflammation and Infection (APSOII), the Asia-Pacific Vitreo-Retina Society (APVRS), the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO) and The Infectious Uveitis Treatment Algorithm Network (TITAN) Group

This international consensus effort, convened by The Infectious Uveitis Treatment Algorithm Network ( TITAN) group, brought together 103 uveitis experts to address long-standing controversies in the management of ocular toxoplasmosis (OT), a leading cause of infectious posterior uveitis worldwide. Despite the availability of advanced diagnostic tools, variability persists in clinical decision-making. Controversies were identified from previous surveys on OT management, which served as the foundation for developing the survey questions in this study. Using a two-round modified Delphi method, experts reviewed evidence and rated recommendations across three domains: diagnosis and investigations, treatment, and follow-up management. Key consensus findings include support for antiparasitic therapy in most active cases, selective use of polymerase chain reaction (PCR) testing for atypical presentations, and prophylactic therapy in high-risk scenarios. These expert-derived consensus provide a framework for best practices in OT clinical management and highlight priorities for future prospective studies.