Hashida Noriyasu, Nakai Kei, Nishida Kohji
Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
Case Rep Ophthalmol. 2014 Jan 8;5(1):16-21. doi: 10.1159/000358191. eCollection 2014 Jan.
To study a case with intraretinal Toxocara larvae in a granuloma using high-penetration optical coherence tomography (HP-OCT).
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.
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.
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.
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。
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。
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。
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。