Eye Associates of Utica, PC, Utica, NY, USA.
Cornea. 2010 Jun;29(6):703-5. doi: 10.1097/ICO.0b013e3181c296d6.
To describe the technique of Nd:YAG photodestruction of a presumed Toxocara canis corneal larval migrans and to report the unique clinical combination of a corneal nematode and diffuse unilateral subacute neuroretinitis (DUSN).
Clinical case report.
A 63-year-old white male presented with idiopathic neuroretinitis treated empirically with systemic anti inflammatory therapy. Subsequently, he developed keratouveitis with an obvious corneal larva. Serology was positive for T. canis. Laser destruction of the larva combined with topical steroid and oral albendazole therapy led to initial resolution, followed by 1 episode of recurrent keratouveitis without identified ocular surface or intraocular larvae. This was cleared with topical steroids. A second empiric course of oral albendazole was also administered. The patient has shown no ocular recurrences or evidence of systemic involvement 1 year after the second course of treatment.
Corneal larvae can be safely and successfully destroyed by Nd:YAG photodestruction. T. canis may be one of several nematodes responsible for DUSN. A careful examination of the anterior segment is essential in the management of patients with DUSN.
描述疑似犬弓蛔虫性角膜幼虫移行症的 Nd:YAG 光破坏技术，并报告一种独特的临床组合，即角膜线虫和弥漫性单侧亚急性神经视网膜炎（DUSN）。
临床病例报告。
一名 63 岁白人男性因特发性神经视网膜炎，经经验性全身抗炎治疗。随后，他出现了伴有明显角膜幼虫的 keratouveitis。血清学检查对犬弓蛔虫呈阳性。幼虫的激光破坏联合局部皮质类固醇和口服阿苯达唑治疗导致最初的缓解，随后出现 1 次复发性 keratouveitis，但未发现眼表或眼内幼虫。这通过局部皮质类固醇治疗得到了缓解。还给予了第二次经验性口服阿苯达唑治疗。在第二次治疗后 1 年，患者没有出现眼部复发或全身受累的迹象。
Nd:YAG 光破坏可安全有效地破坏角膜幼虫。犬弓蛔虫可能是导致 DUSN 的几种线虫之一。在管理 DUSN 患者时，仔细检查前段是必不可少的。
