Following the migration of a Toxocara larva in the retina by optical coherence tomography and fluorescein angiography

Suzuki, Takashi; Joko, Takeshi; Akao, Nobuaki; Ohashi, Yuichi

doi:10.1007/s10384-004-0157-9

Cited by 24 publications

(10 citation statements)

References 4 publications

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“…In this report, we demonstrated a continuous and a discontinuous pattern of intraocular migration. These patterns have been individually reported in different case reports [22], [23], but their incidences have not been determined in longitudinal studies with a large number of patients. Our study showed that 12.9% and 4.3% of patients had continuous and discontinuous migration, respectively.…”

Section: Discussionmentioning

confidence: 98%

Clinical Features and Course of Ocular Toxocariasis in Adults

et al. 2014

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PurposeTo investigate the clinical features, clinical course of granuloma, serologic findings, treatment outcome, and probable infection sources in adult patients with ocular toxocariasis (OT).MethodsIn this retrospective cohort study, we examined 101 adult patients diagnosed clinically and serologically with OT. Serial fundus photographs and spectral domain optical coherence tomography images of all the patients were reviewed. A clinic-based case-control study on pet ownership, occupation, and raw meat ingestion history was performed to investigate the possible infection sources.ResultsAmong the patients diagnosed clinically and serologically with OT, 69.6% showed elevated immunoglobulin E (IgE) levels. Granuloma in OT involved all retinal layers and several vitreoretinal comorbidities were noted depending on the location of granuloma: posterior pole granuloma was associated with epiretinal membrane and retinal nerve fiber layer defects, whereas peripheral granuloma was associated with vitreous opacity. Intraocular migration of granuloma was observed in 15 of 93 patients (16.1%). Treatment with albendazole (400 mg twice a day for 2 weeks) and corticosteroids (oral prednisolone; 0.5–1 mg/kg/day) resulted in comparable outcomes to patients on corticosteroid monotherapy; however, the 6-month recurrence rate in patients treated with combined therapy (17.4%) was significantly lower than that in patients treated with corticosteroid monotherapy (54.5%, P = 0.045). Ingestion of raw cow liver (80.8%) or meat (71.2%) was significantly more common in OT patients than healthy controls.ConclusionsOur study discusses the diagnosis, treatment, and prevention strategies for OT. Evaluation of total IgE, in addition to anti-toxocara antibody, can assist in the serologic diagnosis of OT. Combined albendazole and corticosteroid therapy may reduce intraocular inflammation and recurrence. Migrating feature of granuloma is clinically important and may further suggest the diagnosis of OT. Clinicians need to carefully examine comorbid conditions for OT. OT may be associated with ingestion of uncooked meat, especially raw cow liver, in adult patients.

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Section: Discussionmentioning

confidence: 98%

Clinical Features and Course of Ocular Toxocariasis in Adults

et al. 2014

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“…According to a previous report [5], using conventional OCT, the retinal lesions of ocular toxocariasis were thought to be diagnosed differentially from idiopathic choroidal neovascularization, probably because the view is blocked by the lesions and the conditions from the deep layer of the retina to the choroid are unclear. It is difficult to draw the images of the chorioretinal lesions of ocular toxocariasis using commercially available OCT using a scanning laser with a shorter wavelength of about 840 nm; the inner retinal layers usually show a high reflectivity with adjacent areas of low or no reflectivity [5, 6]. HP-OCT with a long wavelength light source of about 1,050 nm allows visualization of the posterior choroid and sclera [8].…”

Section: Discussionmentioning

confidence: 99%

“…Optical coherence tomography (OCT) is useful for noninvasively examining these intraretinal lesions. Previous studies have reported using OCT to examine the chorioretinal lesions of ocular toxocariasis, but delineation of the retina and choroid was unsatisfactory because of insufficient resolution and penetrability [5, 6, 7]. …”

Section: Introductionmentioning

confidence: 99%

Diagnostic Evaluation of Ocular Toxocariasis Using High-Penetration Optical Coherence Tomography

Hashida

Nakai

Nishida

2014

Case Rep Ophthalmol

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Purpose: To study a case with intraretinal Toxocara larvae in a granuloma using high-penetration optical coherence tomography (HP-OCT). Methods: A 50-year-old man, who was referred to our clinic with ocular toxocariasis, initially presented with granuloma formation in the retina. We followed the treatment-associated changes in the toxocariasis lesion by a series of examinations using HP-OCT before and after a systemic corticosteroid and anthelmintic therapy. Results: The posterior pole granuloma initially appeared as a yellowish-white intraretinal lesion with an exudative focus and dye leakage seen on angiography. After therapy, the lesion was no longer exudative. During treatment-free periods, an intraretinal lesion was seen protruding from the retinal surface into the vitreous cavity. HP-OCT confirmed the elevated lesion protruding from the retinal surface into the vitreous cavity. With treatment, the protruding focus flattened during the following 8 months, but the lesion recurred after the treatment stopped. Conclusions: The findings and clinical course strongly suggested ocular toxocariasis. The protruding retinal lesion may have been an ocular manifestation of toxocariasis. HP-OCT was useful in the follow-up and diagnosis.

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“…3) [9, 26, 27]. Two case reports individually demonstrated intraocular migration of granuloma [26, 27].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…3) [9, 26, 27]. Two case reports individually demonstrated intraocular migration of granuloma [26, 27]. There were two types of intraocular migration, continuous (granuloma migrated adjacent to the originally observed location) or discontinuous (a new granuloma far from the original location) [9].…”

Section: Clinical Featuresmentioning

confidence: 99%

Ocular toxocariasis: clinical features, diagnosis, treatment, and prevention

Ahn

Ryoo

Woo

2014

Asia Pacific Allergy

103

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Despite being one of the most common zoonotic infections worldwide, human toxocariasis has been one of the neglected tropical diseases. Although most human infections are asymptomatic, two main syndromes of human toxocariasis are classically recognized: systemic toxocariasis, which encompasses diseases in major organs; and ocular toxocariasis (OT), disease in the eye or optic nerve, caused by the migration of Toxocara larvae into the eye. OT is usually a unilateral disease, which typically presents as retinal granuloma, a yellowish or whitish inflammatory mass, in the posterior pole or peripheral retina. Granuloma itself or other comorbid conditions such as epiretinal membrane, macular edema, and retinal detachment can lead to permanent retinal damage and visual loss in eyes with OT. OT is diagnosed clinically by identification of clinical signs on ophthalmologic examination. Serological tests, such as enzyme-linked immunosorbent assay (ELISA) for detection of serum antibody against the Toxocara larvae, can confirm the diagnosis. In addition, serum immunoglobulin E and detection of ocular fluid antitoxocara antibody by ELISA may give additional aid to the diagnosis. Standard treatment of OT is corticosteroid in patients with active intraocular inflammation. Although the role of anthelmintic therapy is unclear, favorable outcome has been reported by combined corticosteroid and albendazole therapy in eyes with active inflammation. Prevention, by increasing public awareness and reducing the risk of infection, is also important. Recently, the association between ingestion of uncooked meat or liver and toxocariasis was reported, especially in adult patients. Future research on the potential source of infection, diagnosis, and treatment should be performed.

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Following the migration of a Toxocara larva in the retina by optical coherence tomography and fluorescein angiography

Abstract: The movement of the lesion from the peripapillary area to the macular area suggested that a Toxocara larva had migrated across the retina. OCT images indicated that the larva moved in the nerve fiber layer, and FA showed that it caused severe inflammation along its pathway.

Cited by 24 publications

References 4 publications

Clinical Features and Course of Ocular Toxocariasis in Adults

Clinical Features and Course of Ocular Toxocariasis in Adults

Diagnostic Evaluation of Ocular Toxocariasis Using High-Penetration Optical Coherence Tomography

Ocular toxocariasis: clinical features, diagnosis, treatment, and prevention

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