Yoshida M, Shirao Y, Asai H, Nagase H, Nakamura H, Okazawa T, Kondo K, Takayanagi T H, Fujita K, Akao N
Department of Public Health, Kanazawa University, Japan.
J Helminthol. 1999 Dec;73(4):357-61. doi: 10.1017/s0022149x99000608.
To classify the clinical characteristic of ocular toxocariasis in Japan, the prevalence of antibodies to Toxocara antigens was examined in patients with uveitis of unknown aetiology. From 1982 to 1993, serum specimens of 383 cases and intraocular fluid samples of 22 cases were serologically screened for Toxocara infection with five immunodiagnostic tests. Fifty-five sera and 11 intravitreous fluid samples were estimated to have significantly high antibody levels against larval excretory-secretory (ES) antigens of T. canis. Eight cases were positive in both serum and vitreous fluid, and three were positive only in the vitreous fluid. Among the 58 antibody positive samples, 20 cases were omitted due to a lack of detailed description of ocular findings. The remaining 38 cases are described in this study. Of these 38 cases, 34 (89%) were older than 20 years of age. Ocular lesions were located in the posterior fundus in 11 cases, in the peripheral fundus in 18 cases, and in both areas in seven cases. Of the eight cases in which papillary oedema or redness was observed, chorioretinal lesions were also present in seven of them. Tractional retinal detachment was present in five cases. These observations suggest that ocular toxocariasis in Japan has a different clinical profile compared with those in the other countries, and indicate a need for revised classification of ocular toxocariasis.
为了明确日本眼弓蛔虫病的临床特征,我们对病因不明的葡萄膜炎患者进行了弓蛔虫抗原抗体患病率检测。1982年至1993年期间,我们采用五种免疫诊断试验对383例患者的血清标本和22例患者的眼内液样本进行了弓蛔虫感染的血清学筛查。55份血清样本和11份玻璃体液样本被估计针对犬弓蛔虫幼虫排泄分泌(ES)抗原具有显著高水平的抗体。8例患者血清和玻璃体液均呈阳性,3例仅玻璃体液呈阳性。在58份抗体阳性样本中,20例因缺乏眼部检查结果的详细描述而被排除。本研究描述了其余38例病例。在这38例病例中,34例(89%)年龄超过20岁。眼部病变位于眼底后部11例,周边眼底18例,两个区域均有病变7例。在观察到乳头水肿或充血的8例病例中,7例同时存在脉络膜视网膜病变。5例存在牵拉性视网膜脱离。这些观察结果表明,日本的眼弓蛔虫病与其他国家具有不同的临床特征,提示需要对眼弓蛔虫病进行修订分类。