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

被引:64
作者
Ahn, Seong Joon [1 ,2 ]
Ryoo, Na-Kyung [1 ]
Woo, Se Joon [1 ]
机构
[1] Seoul Natl Univ, Seoul Natl Univ Bundang Hosp, Coll Med, Dept Ophthalmol, 82 Gumi Ro,173beon Gil, Seongnam 463707, South Korea
[2] Armed Forces Capital Hosp, Dept Ophthalmol, Seongnam 463040, South Korea
关键词
Diagnosis; Toxocariasis; Treatment; Ocular toxocariasis;
D O I
10.5415/apallergy.2014.4.3.134
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
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.
引用
收藏
页码:134 / 141
页数:8
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