The Clinical Characteristics of Ocular Toxocariasis in Jeju Island Using Ultra-wide-field Fundus Photography.
10.3341/jkos.2017.58.5.554
- Author:
Jong Young LEE
1
;
Jin Young KIM
;
Sang Yoon LEE
;
Hye Jin LEE
;
Jin Ho JEONG
;
Eun Kyoung LEE
Author Information
1. Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea. righthanded8282@gmail.com
- Publication Type:Original Article
- Keywords:
Ocular toxocariasis;
Toxocariasis;
Ultra-wide-field fundus photography;
Uveitis
- MeSH:
Albendazole;
Anterior Chamber;
Diagnosis;
Fluorescein Angiography;
Follow-Up Studies;
Granuloma;
Humans;
Immunoglobulin G;
Incidence;
Inflammation;
Medical Records;
Photography*;
Prednisolone;
Recurrence;
Retinaldehyde;
Retrospective Studies;
Serologic Tests;
Tomography, Optical Coherence;
Toxocara canis;
Toxocariasis*;
Uveitis;
Visual Acuity
- From:Journal of the Korean Ophthalmological Society
2017;58(5):554-562
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To investigate the clinical features and treatment outcomes of ocular toxocariasis in Jeju Island using ultra-wide-field fundus photography. METHODS: We retrospectively reviewed the medical records of 40 eyes of 37 patients who were diagnosed with ocular toxocariasis based on clinical aspects and serologic tests. The quality of history-taking was assessed and peripheral blood samples were analyzed. Ocular characteristics were evaluated using ultra-wide-field fundus photography and optical coherence tomography. Changes in visual acuity and funduscopic findings after treatment were also analyzed. RESULTS: The average age of the patients was 57.9 years and the mean Toxocara canis IgG titer was 1.979 ± 0.486. The most common fundus findings were vitreous opacity (63.6%) and granuloma (60%). Granulomas that were not initially observed within the field of view of conventional fundus photography were found using ultra-wide-field imaging in 15 eyes (62.5%). Ultra-wide-field fluorescein angiography showed peripheral vascular leakage in 16 eyes (69.6%). Treatment with oral prednisolone and albendazole resulted in average vision improvements of 0.19 ± 0.07 logMAR (p = 0.031) as well as significant improvements in anterior chamber inflammation and vitreous opacity. Combination therapy led to a significantly lower recurrence rate than prednisolone monotherapy (p = 0.049). CONCLUSIONS: In Jeju Island, the mean Toxocara canis IgG titer of ocular toxocariasis was high. The incidences of vitreous opacity and granulomas were also high. Ultra-wide-field fundus imaging was useful for finding peripheral retinal lesions and peripheral vascular leakage that were not observed within the field of view of conventional fundus photography. Ultra-wide-field fundus imaging was valuable not only during clinical diagnosis, but also on follow-up evaluations of ocular toxocariasis. Treatment with oral prednisolone and albendazole effectively improved ocular inflammation and visual acuity and helped reduce the recurrence rate.
