J Korean Ophthalmol Soc > Volume 58(5); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(5):554-562.
DOI: https://doi.org/10.3341/jkos.2017.58.5.554    Published online May 15, 2017.
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


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