Morais Fábio Barreto, Maciel Ana Lúcia, Arantes Tiago Eugênio Farias e, Muccioli Cristina, Allemann Norma
Setor de Ultrassonografia Ocular, Departamento de Oftalmologia, Universidade Federal de São Paulo, Brazil.
Arq Bras Oftalmol. 2012 Jan-Feb;75(1):43-7. doi: 10.1590/s0004-27492012000100009.
To evaluate ophthalmic ultrasound findings in the three presentation forms of ocular toxocariasis (peripheral or posterior pole granulomas and chronic endophthalmitis), in patients with confirmed diagnosis of ocular toxocariasis.
11 patients (11 eyes) with clinical and confirmed diagnosis of active ocular toxocariasis, presented positive ELISA test, were analyzed, prospectively, in the study. The patients were submitted to an ocular ultrasound examination (10-MHz transducer, contact technique).
In the series of 11 patients, mean age was 7.9 years-old (range from 2 to 17 y), 73% male, referring previous contact with dogs (91%), and with the soil (50%), no referral of appetite perversion. In the analyses of compromised eyes (11 eyes), the ophthalmoscopic examination revealed the following distribution of the 3 forms of ocular toxocariasis: 7 cases (63.6%), posterior pole granuloma; 1 (9.1%), chronic endophthalmitis; 2 (18.2%), peripheral granuloma; and 1 (9.1%), posterior pole granuloma associated with chronic endophthalmitis. Visual acuity impairment: no light perception (3 eyes, 27.3%); hand motion (4 eyes, 36.4%); counting fingers at 10 cm (1 eye, 9.1%); 20/200 (1 eye, 9.1%); 20/70 (1 eye, 9.1%); undefined (1 eye, 9.1%). Serology was positive to Toxocara canis (ELISA test) in 100% of the cases. Ophthalmoscopy was difficult or impossible in 64% of the cases due to the media opacity. Ultrasound findings noted were vitreous membranes with retinal attachment (100%); parietal lesions (granulomas) with high (80%) or medium (20%) reflectivity.
The most consistent ultrasound finding in the eye with toxocariasis was a high-reflectivity retinal mass, located in posterior pole or periphery, which may be calcified, and which has as main characteristic the adherence of vitreous membranes. In addition to clinical history, systemic evaluation and serology, the ultrasound can help in the diagnosis of ocular toxocariasis, especially in media opacities.
评估经确诊的眼弓蛔虫病患者眼弓蛔虫病三种表现形式（周边或后极部肉芽肿以及慢性眼内炎）的眼科超声检查结果。
对11例临床诊断为活动性眼弓蛔虫病且确诊、酶联免疫吸附测定（ELISA）试验呈阳性的患者（11只眼）进行前瞻性分析研究。患者接受眼科超声检查（10兆赫探头，接触式技术）。
在这11例患者中，平均年龄为7.9岁（范围为2至17岁），73%为男性，既往有接触狗（91%）和接触土壤（50%）史，无食欲异常情况。在对患眼（11只眼）的分析中，眼科检查显示眼弓蛔虫病三种表现形式的分布如下：7例（63.6%）为后极部肉芽肿；1例（9.1%）为慢性眼内炎；2例（18.2%）为周边肉芽肿；1例（9.1%）为后极部肉芽肿合并慢性眼内炎。视力损害情况：无光感（3只眼，27.3%）；手动（4只眼，36.4%）；在10厘米处数指（1只眼，9.1%）；20/200（1只眼，9.1%）；20/70（1只眼，9.1%）；不明确（1只眼，9.1%）。所有病例的血清学检查对犬弓蛔虫均呈阳性（ELISA试验）。64%的病例因介质混浊，眼科检查困难或无法进行。超声检查结果显示有视网膜附着的玻璃体膜（100%）；有高反射率（80%）或中等反射率（20%）的壁层病变（肉芽肿）。
眼弓蛔虫病患者眼部最一致的超声检查结果是位于后极部或周边的高反射率视网膜肿物，可能已钙化，其主要特征是玻璃体膜附着。除临床病史、全身评估和血清学检查外，超声检查有助于眼弓蛔虫病的诊断，尤其是在介质混浊的情况下。
