Hu Xiao-Feng, Feng Jing, Kang Hao, Wang Hui, Liu Xu-Hui, Tao Yong
Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450046, Henan Province, China.
Int J Ophthalmol. 2022 Mar 18;15(3):401-406. doi: 10.18240/ijo.2022.03.05. eCollection 2022.
To investigate the clinical features of adult patients with ocular toxocariasis (OT) in north China and to diagnose adults OT patients in early stage.
Clinical data of 24 adults with OT were retrospectively analyzed. Slit lamp photographs and fundus photographs and other imaging examinations of all the patients were reviewed. A questionnaire concerning the pet ownership and place of residence was completed to investigate the possible infection origin. Descriptive statistical analyses were performed on the demographic data, clinical features, funduscopic findings and ELISA results.
Among the 24 patients diagnosed with OT by Toxocara IgG antibody in intraocular fluid, 16 (66.7%) eyes were right eye. The onset age of 12 eyes (50.0%) was between 30 and 40 years old, and 21 (87.5%) eyes were of peripheral granuloma type. The most common sign was vitreous opacity. Granulomas were detected in all the eyes, and 20 (83.3%) patients resided in rural area. In 4 patients, the concentration of anti-Toxocara antibody both in anterior humor and in vitreous humor were detected, and the results showed the concentration in vitreous humor was much higher than aqueous humor.
Our study analyzes the clinical manifestation of OT in adults, which may have been under-recognized before. Eye side, residence, and detection of granuloma may help us in diagnosis of OT in patients with monocular vitreous opacity. For adult patients with presumed OT, negative results of anti-Toxocara antibody in anterior humor cannot rule out the possibility of OT, further detection of vitreous humor is suggested for final diagnosis.
探讨中国北方成人眼弓蛔虫病（OT）患者的临床特征，并对成人OT患者进行早期诊断。
回顾性分析24例成人OT患者的临床资料。复查所有患者的裂隙灯照片、眼底照片及其他影像学检查。完成一份关于宠物饲养情况和居住地点的问卷，以调查可能的感染源。对人口统计学数据、临床特征、眼底检查结果和酶联免疫吸附测定（ELISA）结果进行描述性统计分析。
在24例经眼内液中弓蛔虫IgG抗体诊断为OT的患者中，16只眼（66.7%）为右眼。12只眼（50.0%）的发病年龄在30至40岁之间，21只眼（87.5%）为周边肉芽肿型。最常见的体征是玻璃体混浊。所有眼中均检测到肉芽肿，20例（83.3%）患者居住在农村地区。对4例患者检测了房水和玻璃体内抗弓蛔虫抗体浓度，结果显示玻璃体内浓度远高于房水。
我们的研究分析了成人OT的临床表现，此前可能未得到充分认识。患眼侧别、居住地及肉芽肿的检测有助于我们对单眼玻璃体混浊患者诊断OT。对于疑似OT的成人患者，房水中抗弓蛔虫抗体阴性结果不能排除OT的可能性，建议进一步检测玻璃体以明确诊断。
