The Clinical Characteristics of Ocular Toxocariasis in Jeju Island Using Ultra-wide-field Fundus Photography. |
Jong Young Lee, Jin Young Kim, Sang Yoon Lee, Hye Jin Lee, Jin Ho Jeong, Eun Kyoung Lee |
Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea. righthanded8282@gmail.com |
초광범위안저촬영술을 이용한 제주도 지역에서의 눈개회충증의 임상양상 분석 |
이종영⋅김진영⋅이상윤⋅이혜진⋅정진호⋅이은경 |
제주대학교 의학전문대학원 안과학교실 |
Correspondence:
Eun Kyoung Lee, Email: righthanded8282@gmail.com |
Received: 26 January 2017 • Revised: 22 March 2017 • Accepted: 21 April 2017 |
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. |
Key Words:
Ocular toxocariasis;Toxocariasis;Ultra-wide-field fundus photography;Uveitis |