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中国东部地区眼弓蛔虫病的临床特征。

Clinical characteristics of ocular toxocariasis in Eastern China.

机构信息

Department of Ophthalmology, Fudan University Eye and ENT Hospital, Fudan University, 83 Fenyang Rd, Shanghai, China.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2012 Sep;250(9):1373-8. doi: 10.1007/s00417-012-1971-2. Epub 2012 Feb 28.

Abstract

PURPOSE

To explore the clinical characteristics of patients with ocular toxocariasis in eastern China.

METHODS

The medical records of 35 cases of ocular toxocariasis in Fudan University Eye & ENT Hospital between May 2009 and April 2011 were retrospectively reviewed and analyzed. UBM, RetCam or fundus imaging, and high-frequency or conventional ultrasonography were performed in these patients.

RESULTS

The mean patient age in our series of ocular toxocariasis was 11.86 ± 8.80 years. There were 28 children and seven adults, the majority residing in a rural area (88.57%). All cases were classified into three clinical subtypes: granuloma in the peripheral retina (60% of cases); granuloma in the posterior pole (28.57% of cases); and vitreous inflammation mimicking chronic endophthalmitis (5.71% of cases). We also identified an additional subtype with unique clinical features that we termed "combined type" presenting in 5.71% of our patients. This subtype exhibited granulomas in both the posterior pole and peripheral retina. RetCam fundus imaging was able to identify granulomas in the posterior and peripheral subtypes, 100% and 80.95% of cases respectively. Moreover, UBM combined with conventional ultrasonography identified granulomas in 95% of the peripheral subtype cases and in 100% of the posterior pole subtype cases.

CONCLUSIONS

This is the first ocular toxocariasis series described in Chinese patients. Compared with reports from developed countries, the ocular features in our series were more severe and complicated, presenting with poorer visual acuity and a high rate of retinal detachment (45.7%). The application of RetCam and UBM during examination in ocular toxocariasis can provide valuable information in determining the severity of disease and features important in considering surgical procedures in such patients.

摘要

目的

探讨华东地区眼弓蛔虫病患者的临床特征。

方法

回顾性分析 2009 年 5 月至 2011 年 4 月复旦大学附属眼耳鼻喉科医院收治的 35 例眼弓蛔虫病患者的临床资料。所有患者均行超声生物显微镜(UBM)、RetCam 或眼底成像、高频或常规超声检查。

结果

本系列眼弓蛔虫病患者的平均年龄为 11.86±8.80 岁,其中 28 例为儿童,7 例为成人,多数患者(88.57%)来自农村。所有患者均分为 3 种临床亚型:周边部视网膜肉芽肿(60%);后极部视网膜肉芽肿(28.57%);玻璃体炎症类似于慢性眼内炎(5.71%)。我们还发现了一种具有独特临床特征的附加亚型,在我们的患者中占 5.71%,称为“混合型”。该亚型在后极部和周边部均有肉芽肿。RetCam 眼底成像能识别后极部和周边部亚型的肉芽肿,分别为 100%和 80.95%。此外,UBM 联合常规超声检查能识别 95%的周边部亚型和 100%的后极部亚型的肉芽肿。

结论

这是首例中国患者的眼弓蛔虫病系列报道。与发达国家的报道相比,本系列患者的眼部表现更严重、更复杂,视力更差,视网膜脱离发生率更高(45.7%)。在眼弓蛔虫病检查中应用 RetCam 和 UBM 可以提供有价值的信息,有助于确定疾病的严重程度和考虑手术的重要特征。

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