Abd El-Aal N F, Basha M A A, Eid A M
Department of Medical Parasitology, Faculty of Medicine, Zagazig University, Egypt.
Department of Radiology, Faculty of Medicine, Zagazig University, Egypt.
J Helminthol. 2018 Nov 20;94:e12. doi: 10.1017/S0022149X18000895.
Uveitis is one of the commonest causes of vision loss worldwide and its exact etiology is still not clarified in most patients. The current study is a trial to assess the efficacy of serum anti-Toxocara immunoglobulin G (IgG) by enzyme-linked immunosorbent assay (ELISA) as a diagnostic tool for ocular toxocariasis (OT) and to detect OT prevalence and the associated ocular manifestations in sera of patients with uveitis. One hundred and twelve patients (62 females and 50 males) with uveitis were diagnosed by ophthalmologists, radiologists and rheumatologists according to ocular manifestations, laboratory and radiological investigations. Serum anti-Toxocara IgG titers were determined by ELISA in sera of all patients. Our results revealed that OT is highly associated with intermediate and posterior uveitis. Children and young adult females, especially those residing in rural areas, complained mainly of diminution of vision in the left eye, with strabismus and leukocoria. At a cut-off value of 0.258, the sensitivity and specificity of IgG ELISA were 93.3% and 100%, respectively. In conclusion, at a novel cut-off value of 0.258 the serum anti-Toxocara IgG ELISA is predicted to be a diagnostic tool for OT regarding sensitivity and specificity. Also, it has potential importance in the interpretation and differential diagnosis of OT. Thus, serum anti-Toxocara IgG ELISA should be a routine test for screening of suspected cases.
葡萄膜炎是全球范围内导致视力丧失的最常见原因之一,在大多数患者中其确切病因仍未明确。本研究旨在通过酶联免疫吸附测定(ELISA)评估血清抗弓蛔虫免疫球蛋白G(IgG)作为眼弓蛔虫病(OT)诊断工具的有效性,并检测葡萄膜炎患者血清中OT的患病率及相关眼部表现。112例葡萄膜炎患者(62例女性和50例男性)由眼科医生、放射科医生和风湿病学家根据眼部表现、实验室检查和影像学检查进行诊断。所有患者血清中抗弓蛔虫IgG滴度通过ELISA测定。我们的结果显示,OT与中间葡萄膜炎和后葡萄膜炎高度相关。儿童和年轻成年女性,尤其是居住在农村地区的患者,主要抱怨左眼视力下降,伴有斜视和白瞳症。在临界值为0.258时,IgG ELISA的敏感性和特异性分别为93.3%和100%。总之,在新的临界值0.258时,血清抗弓蛔虫IgG ELISA在敏感性和特异性方面有望成为OT的诊断工具。此外,它在OT的诊断和鉴别诊断中具有潜在重要性。因此,血清抗弓蛔虫IgG ELISA应作为疑似病例筛查的常规检查。