Retinoblastoma in children, experience at a pediatric hospitalMethods: Retrospective analysis of clinical charts of 41 children (59 eyes) diagnosed with retinoblastoma and treated by a multidisciplinary team at Hospital Luis Calvo Mackenna in Santiago-Chile, between 1999 and 2007. The information included gender, laterality, diagnosis age, presenting signs, tumor spread, treatment modality and survival rate. Results: A total of 23 cases (56%) were unilateral and 18 cases (44%) were bilateral. The mean age at diagnosis was 21.6 months (range 2 -84) and 27 children (65.9%) were male. The most common presenting signs were leucokoria (51.2%), strabismus (24.4%) and proptosis (4.9%). Enucleation was performed in 48 eyes (81.3%), being the only required treatment in 17 children (41.5%). The remaining 24 patients received systemic and/or local therapy with chemotherapy, focal therapy and external beam radiation. 5 children died during the follow -up study period, due to extraocular extension to the orbit, central nervous system and bone marrow. Conclusion: In spite of high enucleation rate as initial therapy for retinoblastoma, the survival rate with this current treatment protocol is similar to those from developed countries.
Prevalence of ocular lesions in children seropositive to Toxocara canisIntraocular invasion by Toxocara canis is one of the most commonly recognized etiologies of uveitis and blindness in children. In order to estimate the prevalence of ocular lesions caused by toxocariasis in a pediatric referral hospital, we conducted a retrospective analysis of clinical charts of all children seropositive to Toxocara canis, who also had an eye exam between the years 2005 and 2009 at the Calvo Mackenna Children´s Hospital in Santiago, Chile. We identifi ed 175 children [mean age 6 years (range 0.66-15)] seropositive to Toxocara canis, who had dilated eye exam. Only one child [(0.57%); 95% CI, -0.55 -1.69] had ophthalmoscopic fi ndings compatible with Toxocara canis infection. The patient also suffered from decreased vision of the affected eye. The information gained from this study may be of useful for the implementation of algorithms for the ophthalmological examination of children seropositive to Toxocara canis in public hospitals in Chile.Key words: Toxocariasis, ocular, prevalence, eye infections (parasitic). Palabras clave: Toxocariosis, ocular, prevalencia, infecciones oculares parasitarias. Hospital Luis CalvoMackenna, Santiago, Chile.Unidad de Oftalmología (JEST, JPLG, MGN, EVD, DMM, ARB). Unidad de Parasitología (INH, AVA).Los autores no tienen conflicto de interés con los métodos y/o pacientes que aparecen en el presente estudio. Recibido: 10 de diciembre de 2010Aceptado: 11 de mayo de 2011Correspondencia a:Introducción L a toxocariosis ocular es una forma de infl amación intraocular debida a la invasión del segmento posterior del ojo por el nematodo Toxocara canis. Constituye una de las causas más frecuentes de uveitis posterior en los niños, pudiendo ocasionar graves complicaciones intraoculares conducentes a la ceguera 1-3 . Se ha reportado una variable prevalencia de seropositividad (prueba serológica inmunoabsorbente ELISA) para T. canis. Por ejemplo, en un estudio realizado en Barcelona 4 , incluyendo un gran número de donantes de sangre sanos y pacientes con hipereosinofi lia y otras helmintiasis, se estimó 3,6% de seropositividad. En otro estudio realizado en la República Checa 5 en población general de distintos distritos, la prevalencia varió entre 5,8 y 36%, siendo más alta en las áreas rurales. No obstante, los datos extraídos de la literatura internacional indican que existe una muy variable prevalencia de lesiones oculares en los niños con serología positiva para T. canis, que podría fl uctuar entre 0% en niños asintomáticos de kindergarten 6 y 27,7% en niños con diagnóstico presuntivo de toxocariosis 7 .Chile es un país con alta prevalencia general de títulos positivos para T. canis, estimándose en 8,8% 8 en adultos sanos. Esta cifra consideró como positivo los títulos de ELISA ≥ 1:64 (valor superior en dos desviaciones estánda-res al promedio). No obstante, la prevalencia de lesiones oculares en niños asintomáticos con serología positiva para T. canis o con clínica de toxocariosis sistémica es descono...
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