Tran V T, Lumbroso L, LeHoang P, Herbort C P
Department of Ophthalmology, Hôpital Jules Gonin, University of Lausanne, Switzerland.
Am J Ophthalmol. 1999 May;127(5):607-9. doi: 10.1016/s0002-9394(98)00403-6.
To report ultrasound biomicroscopic features in peripheral retinovitreal Toxocara uveitis.
Three patients with unilateral vitreitis suspected to be caused by peripheral toxocariasis were referred for ultrasound biomicroscopic examination of the peripheral retina, pars plana, and adjacent vitreous.
In two of the three patients, characteristic pseudocystic transformation of the peripheral vitreous was seen. In both patients, Toxocara serology was positive and eosinophilia was present. In the third patient, no pseudocystic transformation of the peripheral vitreous was seen; however, there was the dense thickening adjacent to the pars plana usually seen by ultrasound biomicroscopy in pars planitis and corresponding to clinically visible snowbanks. The third patient had a negative Toxocara serology and later developed bilateral intermediate uveitis of the pars planitis type. In none of 48 patients with diverse inflammatory conditions of the retroiridal space that were examined by ultrasound biomicroscopy were the characteristic Toxocara-associated pseudocystic images seen.
Pseudocystic transformation of the peripheral vitreous appears to be a rather specific and sensitive ultrasound biomicroscopic sign in patients with presumed peripheral toxocariasis that will likely aid diagnosis in difficult cases.
报告周边视网膜玻璃体弓蛔虫性葡萄膜炎的超声生物显微镜特征。
3例疑似由周边弓蛔虫病引起单侧玻璃体炎的患者被转诊接受周边视网膜、睫状体平坦部及相邻玻璃体的超声生物显微镜检查。
3例患者中有2例可见周边玻璃体特征性的假性囊肿样改变。这2例患者弓蛔虫血清学检查均为阳性且存在嗜酸性粒细胞增多。第3例患者未见周边玻璃体假性囊肿样改变；然而，在睫状体平坦部附近有密集增厚，这在超声生物显微镜检查中常见于睫状体平坦部炎，且与临床上可见的雪堤样病变相对应。第3例患者弓蛔虫血清学检查为阴性，随后发展为双侧睫状体平坦部炎型中间葡萄膜炎。在接受超声生物显微镜检查的48例具有不同类型虹膜后间隙炎症的患者中，均未见到与弓蛔虫相关的特征性假性囊肿样图像。
周边玻璃体假性囊肿样改变似乎是疑似周边弓蛔虫病患者一种相当特异且敏感的超声生物显微镜征象，可能有助于疑难病例的诊断。
