Pediatric Ocular Toxocariasis in Costa Rica: 1998-2018 Experience

Martínez, José Belmonte; Ivankovich‐Escoto, Gabriela; Wu, Lihteh

doi:10.1080/09273948.2020.1792513

Cited by 12 publications

(5 citation statements)

References 24 publications

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“…A retrospective study covering 20 years of management of pediatric OT in Costa Rica analyzed five cases that were treated with TBZ. No improvement of the best corrected visual acuity was observed [96].…”

Section: Thiabendazole (Tbz)mentioning

confidence: 89%

Therapy and Prevention for Human Toxocariasis

2022

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For the last four decades, knowledge about human toxocariasis with regard to its epidemiology, pathophysiology, clinical spectrum, and imaging or laboratory diagnosis has substantially progressed. Knowledge about specific therapy with anthelmintics has lagged behind. To date, only four drugs are registered for human use, and their efficacy has rarely been assessed in prospective controlled trials. It is likely that the repurposing of potent anthelmintics from veterinary medicine will improve this situation. Due to its wide availability and a lack of major side effects during short regimens, albendazole has become the drug of choice. However, its efficacy should be more precisely assessed. The role of anthelmintics in the treatment of neurological or ocular toxocariasis remains to be clarified. Prophylactic measures in humans or companion animals are efficient and represent first-line treatments for the control of this zoonosis. Unfortunately, their implementation in areas or countries where toxocariasis epidemiology is driven by poverty is quite difficult or unrealistic.

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Section: Thiabendazole (Tbz)mentioning

confidence: 89%

Therapy and Prevention for Human Toxocariasis

2022

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“…Medical treatment includes glucocorticoids and anthelmintic drugs. However, the use of anthelmintics may cause a strong immune response that, if not adequately controlled, can cause significant structural damage to the eye and more serious complications [ 21 ]. As a result, our treatment plan is primarily glucocorticoids combined with vitrectomy.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal Dexamethasone Implant (Ozurdex) for Ocular Toxocariasis

Zhou,

Zhen,

et al. 2024

Journal of Ophthalmology

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This study aimed to evaluate the efficacy and safety of intravitreal dexamethasone implants in the treatment of ocular toxocariasis (OT). A retrospective analysis was performed on 6 cases in which laboratory tests diagnosed OT. All patients were administered with intravitreal dexamethasone implants with or without vitrectomy. The average follow‐up time was 19.7 months. All operated eyes achieved anatomic success, and all patients’ visual acuity was improved. Five of these six had a visual acuity of 20/100, and three had final acuity of 20/40 or even better. Intravitreal dexamethasone implants can be used to treat different types of OT, which not only effectively control inflammation and improve the patient’s vision but also reduce the use of systemic glucocorticoids.

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“…For children, long-term systemic use of steroid drugs can affect the growth and development of the body. Inflammation may recur upon steroid reduction or withdrawal, requiring patients to resume steroids use or increase the dosage ( 29 , 41 ). The indications for PPV are epiretinal membrane, tractional or rhegmatogenous retinal detachment, and severe or persistent vitreous opacity.…”

Section: Discussionmentioning

confidence: 99%

Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children

et al. 2023

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PurposeThis article aims to report a case of successful treatment of peripheral granulomatous ocular toxocariasis (OT) in an 8-year-old patient using intravitreal injection of dexamethasone (DEX) implant (Ozurdex) under ultrasound biomicroscopy (UBM) guidance.Case presentationA previously healthy 8-year-old boy with a history of long-term close contact with dogs complained of blurring of vision in the right eye for a year. Ophthalmic examination of his right eye showed chronic uveitis. Notably, UBM examination identified granulomas and peripheral vitreous strand in the ciliary body from 3 to 8 o'clock positions. Enzyme-linked immunosorbent assay (ELISA) results of the intraocular fluid (IF) and serum showed increased anti-Toxocara immunoglobulin G (IgG) levels, leading to a diagnosis of peripheral granulomatous OT in the right eye. Intraocular surgery was not indicated in this case. The treatment goal was to alleviate uveitis, improve visual acuity, and prevent complications. He was treated with an intravitreal injection of DEX implant, administered as a single dose every three months, total two doses, combined with albendazole, an oral anthelmintic. Under preoperative UBM guidance, two injections were performed at the 12 and 10 o'clock positions in the pars plana where there were no granulomas and peripheral vitreous strand, successfully preventing complications associated with intravitreal injection. After two injections, the patient's right eye vision improved significantly, with the best-corrected visual acuity (BCVA) increasing from 20/400 to 20/50. Vitreous opacity and retinal edema were reduced, preretinal proliferative membrane was stabilized, and no adverse events occurred.ConclusionUBM can accurately determine the location and extent of peripheral granulomas in OT patients, facilitating the avoidance of granulomas during intravitreal injection and preventing complications associated with intravitreal injection. Under the close follow-up and strict adherence to indications, preoperative UBM-guided intravitreal injections of DEX implant treatment for pediatric peripheral granulomatous OT are safe and effective, providing a new therapeutic option for pediatric peripheral granulomatous OT.

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Pediatric Ocular Toxocariasis in Costa Rica: 1998-2018 Experience

Cited by 12 publications

References 24 publications

Therapy and Prevention for Human Toxocariasis

Therapy and Prevention for Human Toxocariasis

Intravitreal Dexamethasone Implant (Ozurdex) for Ocular Toxocariasis

Case report: Ultrasound biomicroscopy as a guide for the selection of injection sites for dexamethasone intravitreal implant (Ozurdex) for peripheral granulomatous ocular toxocariasis in children

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