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眼弓蛔虫病:基于眼科专家调查的流行病学、解剖学和治疗学变化。

Ocular toxocariasis: epidemiologic, anatomic, and therapeutic variations based on a survey of ophthalmic subspecialists.

机构信息

Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

出版信息

Ophthalmology. 2012 Jun;119(6):1211-7. doi: 10.1016/j.ophtha.2011.12.013. Epub 2012 Feb 14.

DOI:10.1016/j.ophtha.2011.12.013
PMID:22336630
Abstract

PURPOSE

To assess the current burden of ocular toxocariasis (OT) and to gain knowledge regarding the diagnostic and treatment practices used in the ophthalmologic community in the United States.

DESIGN

Web-based, cross-sectional survey.

PARTICIPANTS

Subspecialty ophthalmologists who are currently practicing in the United States.

METHODS

An electronic survey was sent to 3020 ophthalmologic subspecialists belonging to the American Uveitis Society (AUS), the American Society of Retina Specialists (ASRS), or the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) to capture demographic, clinical, diagnostic, and treatment data on patients with OT seen in their practices between September 2009 and September 2010.

MAIN OUTCOME MEASURES

The demographic, epidemiologic, and clinical characteristics of each reported patient with OT.

RESULTS

A total of 159 patients with OT were reported by 559 respondents (19%). The median patient age was 11.5 years (range, 1-66 years). Seventy-two patients (45%) with OT lived in the Southern region of the United States. Thirty-one (69%) of 45 patients with OT owned a dog or cat. Vision loss was reported in 46 (85%) of 54 patients with OT; 32 (71%) of 45 patients had permanent vision loss, 13 patients (29%) had temporary vision loss, and duration of vision loss was unreported for 1 patient. Of the 32 patients with OT with permanent vision loss, 30 (94%) had a subretinal granulomatous mass/scar, peripheral granuloma with traction bands, or posterior pole granuloma noted on ophthalmologic examination. Subretinal granulomatous mass/scar, vitritis, and scotoma were the most common ophthalmologic signs found on examination of patients with OT.

CONCLUSIONS

Ocular toxocariasis continues to occur in the United States, where it affects mainly children and causes permanent vision loss in many patients. Healthcare professionals should counsel patients and their family members about prevention strategies in an effort to decrease infection rates and morbidity due to Toxocara. Further improvement of diagnostic and treatment tools is needed to assist ophthalmologists in treating patients with OT.

FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

摘要

目的

评估眼弓蛔虫病(OT)的当前负担,并了解美国眼科医生群体在诊断和治疗方面的实践情况。

设计

基于网络的横断面调查。

参与者

目前在美国执业的眼科亚专科医生。

方法

向美国葡萄膜炎学会(AUS)、美国视网膜专家学会(ASRS)或美国小儿眼科和斜视协会(AAPOS)的 3020 名眼科亚专科医生发送了一份电子调查,以获取 2009 年 9 月至 2010 年 9 月期间他们在实践中诊治的 OT 患者的人口统计学、临床、诊断和治疗数据。

主要观察指标

每位报告的 OT 患者的人口统计学、流行病学和临床特征。

结果

559 名应答者报告了 159 例 OT 患者(19%)。中位患者年龄为 11.5 岁(范围,1-66 岁)。72 例(45%)OT 患者居住在美国南部地区。31 例(69%)OT 患者拥有狗或猫。46 例(85%)OT 患者视力下降;45 例患者中,32 例(71%)有永久性视力丧失,13 例(29%)有暂时性视力丧失,1 例未报告视力丧失持续时间。32 例永久性视力丧失的 OT 患者中,30 例(94%)在眼科检查中发现有视网膜下肉芽肿/瘢痕、周边肉芽肿伴牵引带或后极部肉芽肿。视网膜下肉芽肿/瘢痕、葡萄膜炎和暗点是 OT 患者最常见的眼科体征。

结论

在美国,OT 仍在发生,主要影响儿童,并导致许多患者永久性视力丧失。医疗保健专业人员应向患者及其家属提供有关预防策略的咨询,以降低因弓蛔虫感染引起的发病率和发病率。需要进一步改进诊断和治疗工具,以帮助眼科医生治疗 OT 患者。

利益冲突

作者在本文讨论的任何材料中均无专有权或商业利益。

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