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使用高穿透性光学相干断层扫描技术对眼弓蛔虫病进行诊断评估

Diagnostic evaluation of ocular toxocariasis using high-penetration optical coherence tomography.

作者信息

Hashida Noriyasu, Nakai Kei, Nishida Kohji

机构信息

Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.

出版信息

Case Rep Ophthalmol. 2014 Jan 8;5(1):16-21. doi: 10.1159/000358191. eCollection 2014 Jan.

Abstract

PURPOSE

To study a case with intraretinal Toxocara larvae in a granuloma using high-penetration optical coherence tomography (HP-OCT).

METHODS

A 50-year-old man, who was referred to our clinic with ocular toxocariasis, initially presented with granuloma formation in the retina. We followed the treatment-associated changes in the toxocariasis lesion by a series of examinations using HP-OCT before and after a systemic corticosteroid and anthelmintic therapy.

RESULTS

The posterior pole granuloma initially appeared as a yellowish-white intraretinal lesion with an exudative focus and dye leakage seen on angiography. After therapy, the lesion was no longer exudative. During treatment-free periods, an intraretinal lesion was seen protruding from the retinal surface into the vitreous cavity. HP-OCT confirmed the elevated lesion protruding from the retinal surface into the vitreous cavity. With treatment, the protruding focus flattened during the following 8 months, but the lesion recurred after the treatment stopped.

CONCLUSIONS

The findings and clinical course strongly suggested ocular toxocariasis. The protruding retinal lesion may have been an ocular manifestation of toxocariasis. HP-OCT was useful in the follow-up and diagnosis.

摘要

目的

使用高穿透光学相干断层扫描(HP-OCT)研究一例肉芽肿内视网膜下有犬弓首线虫幼虫的病例。

方法

一名50岁男性因眼弓蛔虫病转诊至我院,最初表现为视网膜肉芽肿形成。我们在全身使用皮质类固醇和驱虫治疗前后,通过一系列HP-OCT检查跟踪弓蛔虫病病变与治疗相关的变化。

结果

后极部肉芽肿最初表现为视网膜内黄白色病变,血管造影可见渗出灶和染料渗漏。治疗后,病变不再渗出。在未治疗期间,可见视网膜内病变从视网膜表面突出至玻璃体腔。HP-OCT证实病变从视网膜表面突出至玻璃体腔。经过治疗,突出灶在接下来的8个月内变平,但治疗停止后病变复发。

结论

这些发现和临床过程强烈提示为眼弓蛔虫病。突出的视网膜病变可能是弓蛔虫病的眼部表现。HP-OCT在随访和诊断中很有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9777/3934803/6a63cbd34ada/cop-0005-0016-g01.jpg

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