Corsi A, Nucci C, Knafelz D, Bulgarini D, Di Iorio L, Polito A, De Risi F, Ardenti Morini F, Paone F M
Cattedra di Ottica Fisiopatologica, Università di Roma Tor Vergata, Italy.
Br J Ophthalmol. 1998 Jan;82(1):59-62. doi: 10.1136/bjo.82.1.59.
The protozoan disease giardiasis can cause ocular complications, including "salt and pepper" retinal changes.
Ophthalmic examinations were performed in 141 children (mean age 4.7 (SD 2.0) years) with active or past giardiasis diagnosed on the basis of microscopic examination of stool specimens or duodenal secretions--53 were newly diagnosed and untreated (group A), 50 had active infections in spite of metronidazole therapy (group B), and 38 had been successfully treated, with negative stool specimens for 1-3 years (group C). 300 children with no evidence of giardiasis were used as controls.
Salt and pepper retinal changes (with normal electroretinographic findings) were diagnosed in 28 (19.9%) of the patients with giardiasis (11 from group A, 10 from group B, and seven from group C), including five pairs of siblings. In all subgroups, the children with retinal changes were consistently younger than those with normal retinas. In eight cases, the lesions could be visualised only with direct ophthalmoscopy.
Our findings indicate that asymptomatic, non-progressive retinal lesions are particularly common in younger children with giardiasis. This risk does not seem to be related to the severity of the infection, its duration, or the use of metronidazole but may reflect a genetic predisposition.
原生动物疾病贾第虫病可引起眼部并发症，包括“椒盐样”视网膜改变。
对141名儿童（平均年龄4.7（标准差2.0）岁）进行眼科检查，这些儿童根据粪便标本或十二指肠分泌物的显微镜检查被诊断为患有现症或既往贾第虫病。其中53名是新诊断且未接受治疗的（A组），50名尽管接受了甲硝唑治疗仍有现症感染（B组），38名已成功治疗，粪便标本在1至3年内呈阴性（C组）。300名无贾第虫病证据的儿童作为对照。
在28名（19.9%）贾第虫病患者中诊断出椒盐样视网膜改变（视网膜电图检查结果正常），其中A组11名，B组10名，C组7名，包括5对兄弟姐妹。在所有亚组中，有视网膜改变的儿童始终比视网膜正常的儿童年龄小。在8例病例中，病变仅通过直接检眼镜检查才能看到。
我们的研究结果表明，无症状、非进行性视网膜病变在患有贾第虫病的年幼儿童中尤为常见。这种风险似乎与感染的严重程度、持续时间或甲硝唑的使用无关，而可能反映了一种遗传易感性。
