Xiaohong Guo1, Hui Liu1, Manli Li1, Ke Fan1, Shuyin Li1, Bo Lei1. 1. Henan Provincial People's Hospital, Henan Eye Institute, Henan Eye Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China.
Abstract
PURPOSE: To analysis the multimodal imaging of a group of patients diagnosed clinically with atypical juvenile ocular toxocariasis (OT). METHODS: In this case series study, we examined 9 young patients diagnosed with atypical OT. Routine ophthalmological examinations, fundus photography, optical-coherence tomography (OCT), fluorescein angiography (FFA), and B-mode ultrasound were performed. A questionnaire was used to record whether the patients were newly diagnosed and whether they had a history of exposure to a cat and dog. Aqueous humor and serum samples were taken for serological tests. RESULTS: In all the patients, yellow-and-white dot-shaped lesions and perivascular white sheath were seen in the fundus. Heterogeneous changes including hyper-reflection in the disrupted neuroretina, hyper-reflection in the outer retinal layer, high-reflection mass on the surface of the neuroretina accompanied with reflective attenuation, and high-reflection mass involving the entire neuroretina or high-reflection mass in the vitreous body were noticed in OCT images. On FFA, seven of these patients (77.8%) showed leakage of fluorescein in the small- and medium-branch veins of the retina, and a "bristle-like" change indicated increased permeability of the vessels. B-mode ultrasound showed proliferative membranes and proliferative bands (33.3%), as well as spotted opacity in the vitreous (66.7%). The antibodies to Toxocara canis in the aqueous humor and serum were positive, and the Goldmann-Witmer coefficient was significantly increased in 6 out of 7 patients. CONCLUSIONS: Multimodality images are useful in the diagnosis of atypical juvenile OT, which could be easily overlooked and misdiagnosed.
PURPOSE: To analysis the multimodal imaging of a group of patients diagnosed clinically with atypical juvenile ocular toxocariasis (OT). METHODS: In this case series study, we examined 9 young patients diagnosed with atypical OT. Routine ophthalmological examinations, fundus photography, optical-coherence tomography (OCT), fluorescein angiography (FFA), and B-mode ultrasound were performed. A questionnaire was used to record whether the patients were newly diagnosed and whether they had a history of exposure to a cat and dog. Aqueous humor and serum samples were taken for serological tests. RESULTS: In all the patients, yellow-and-white dot-shaped lesions and perivascular white sheath were seen in the fundus. Heterogeneous changes including hyper-reflection in the disrupted neuroretina, hyper-reflection in the outer retinal layer, high-reflection mass on the surface of the neuroretina accompanied with reflective attenuation, and high-reflection mass involving the entire neuroretina or high-reflection mass in the vitreous body were noticed in OCT images. On FFA, seven of these patients (77.8%) showed leakage of fluorescein in the small- and medium-branch veins of the retina, and a "bristle-like" change indicated increased permeability of the vessels. B-mode ultrasound showed proliferative membranes and proliferative bands (33.3%), as well as spotted opacity in the vitreous (66.7%). The antibodies to Toxocara canis in the aqueous humor and serum were positive, and the Goldmann-Witmer coefficient was significantly increased in 6 out of 7 patients. CONCLUSIONS: Multimodality images are useful in the diagnosis of atypical juvenile OT, which could be easily overlooked and misdiagnosed.
Authors: Ahmad M Mansour; Bachir Abiad; Fouad I Boulos; Ramzi Alameddine; Fadi C Maalouf; Alaa Bu Ghannam; Rola N Hamam Journal: Case Rep Med Date: 2014-10-09