眼內犬蛔蟲症－病例報告

Ocular Toxocariasis-One Case Report

陳芷郁(Chih-Yu Chen) ； 劉寬鎔(Kwan-Rong Liu)

《中華民國眼科醫學會雜誌》 34卷4期 (1995/12) Pp. 530-535

https://doi.org/10.30048/ACTASOS.199512.0015

摘要

眼內犬蛔蟲症為犬蛔蟲的第二代幼蟲(larva)移行至眼部造成眼內炎，脈絡膜視網膜肉芽腫或造成現網膜剝離等。本篇報告一位三十一歲男子，右眼有突發性視力模糊，初步診斷為未明原因的眼內炎併發極部一肉芽腫及鄰近的牽扯性視網膜剝離影響及黃斑部。我們經向坦部玻璃體切除術移除肉芽腫並解除造成視網膜剝離的牽扯力；而術中所取出的玻璃體經ELISA測定後，證實為眼內犬蛔蟲症；且玻璃體液的細胞學檢查亦發現有多個嗜伊紅性白血球。本病例相當罕見，並可能為台灣首例以玻璃體液之ELISA測定及細胞學檢查證實為眼內犬蛔蟲症，且經坦部玻璃體切除來手術治療的病例。

並列摘要

Ocular toxocariasis is known as nematode endophthalmitis resulting from hematogenous invasion of the eye by the second or third stage larva of the dog roundworm, T. canis. Clinically it may present as acute inflammatory reaction, a posterior/peripheral chorioretinal granuloma, or even tractional retinal detachment. We reported a case of 31-year-old male patient with endophthalmitis combined with a posterior pole granuloma and nearby tractional retinal detachment. The initial result of laboratory workup for pathogens in Japan was all negative. Pars plana vitrectomy was performed to remove the posterior granuloma and release the tractional force of retinal detachment. Vitreous samples were taken during the operation for both cytology study and ELISA test of toxocara. The result of ELISA test was positive and multiple eosinophils were found in the vitreous. Since this patient is probably the first reported case of ELISA-proven ocular toxocariasis treated with pars plana vitrectomy in Taiwan, we presented it here for another possible diagnosis and treatment options for such cases.

並列關鍵字

Toxocariasis ； ocular ； Enzyme-linked immunosorbant assay ELISA