Guo Xiaohong, Liu Hui, Li Manli, Fan Ke, Li Shuyin, Lei Bo
Henan Provincial People's Hospital, Henan Eye Institute, Henan Eye Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
J Ophthalmol. 2021 Feb 11;2021:4853531. doi: 10.1155/2021/4853531. eCollection 2021.
To analysis the multimodal imaging of a group of patients diagnosed clinically with atypical juvenile ocular toxocariasis (OT).
In this case series study, we examined 9 young patients diagnosed with atypical OT. Routine ophthalmological examinations, fundus photography, optical-coherence tomography (OCT), fluorescein angiography (FFA), and B-mode ultrasound were performed. A questionnaire was used to record whether the patients were newly diagnosed and whether they had a history of exposure to a cat and dog. Aqueous humor and serum samples were taken for serological tests.
In all the patients, yellow-and-white dot-shaped lesions and perivascular white sheath were seen in the fundus. Heterogeneous changes including hyper-reflection in the disrupted neuroretina, hyper-reflection in the outer retinal layer, high-reflection mass on the surface of the neuroretina accompanied with reflective attenuation, and high-reflection mass involving the entire neuroretina or high-reflection mass in the vitreous body were noticed in OCT images. On FFA, seven of these patients (77.8%) showed leakage of fluorescein in the small- and medium-branch veins of the retina, and a "bristle-like" change indicated increased permeability of the vessels. B-mode ultrasound showed proliferative membranes and proliferative bands (33.3%), as well as spotted opacity in the vitreous (66.7%). The antibodies to in the aqueous humor and serum were positive, and the Goldmann-Witmer coefficient was significantly increased in 6 out of 7 patients.
Multimodality images are useful in the diagnosis of atypical juvenile OT, which could be easily overlooked and misdiagnosed.
分析一组临床诊断为非典型青少年眼弓蛔虫病（OT）患者的多模态成像。
在本病例系列研究中，我们检查了9例诊断为非典型OT的年轻患者。进行了常规眼科检查、眼底摄影、光学相干断层扫描（OCT）、荧光素血管造影（FFA）和B型超声检查。使用问卷调查记录患者是否为新诊断病例以及是否有接触猫和狗的病史。采集房水和血清样本进行血清学检测。
所有患者眼底均可见黄白色点状病变和血管周围白色鞘膜。OCT图像中观察到包括神经视网膜破坏处高反射、视网膜外层高反射、神经视网膜表面高反射团块伴反射衰减、累及整个神经视网膜的高反射团块或玻璃体中的高反射团块等异质性改变。在FFA检查中，这些患者中有7例（77.8%）视网膜中小分支静脉出现荧光素渗漏，“刷毛样”改变提示血管通透性增加。B型超声显示增殖性膜和增殖带（33.3%），以及玻璃体点状混浊（66.7%）。房水和血清中抗 的抗体呈阳性，7例患者中有6例的戈德曼 - 维特默系数显著升高。
多模态图像有助于非典型青少年OT的诊断，该病容易被忽视和误诊。
