Presentation is loading. Please wait.

Presentation is loading. Please wait.

Ahmed Y. Hatata, MSc Rowayda M. Amin, MSc Assistant Lecturer Ophthalmology Alexandria University, Egypt Toxocariasis.

Similar presentations


Presentation on theme: "Ahmed Y. Hatata, MSc Rowayda M. Amin, MSc Assistant Lecturer Ophthalmology Alexandria University, Egypt Toxocariasis."— Presentation transcript:

1 Ahmed Y. Hatata, MSc Rowayda M. Amin, MSc Assistant Lecturer Ophthalmology Alexandria University, Egypt Toxocariasis

2 History A 28 year old male patient complaining of diminution of vision in the right eye A 28 year old male patient complaining of diminution of vision in the right eye Medical history: free Medical history: free Surgical history: ureter stone surgery 2 months ago Surgical history: ureter stone surgery 2 months ago Family history: free Family history: free Drug history: free Drug history: free

3 First Presentation - Ocular Examination  BCVA: 6/12 OD 6/6 OS  Anterior segment:  Unremarkable OU  Fundus:  O.S.: free  O.D.: white epiretinal mass  close to the fovea with a fibrous band connecting it to the disc

4 First Presentation - FLA  Hyperfluorescent epiretinal mass with increasing fluorescence in late phases due to staining  Tortuous retinal vessels towards the mass due to fibrous tissue traction  Late pooling of the dye around the mass due to mild tractional retinal elevation

5

6

7

8

9 First Examination - OCT

10 First Presentation – Lab Findings  eosinophilia  positive serology for toxocara antibodies (indirect ELISA IgG)

11 Diagnosis Toxocariasis induced Uveitis

12 Treatment  no treatment due to  granuloma outside of the fovea  no systemic manifestations  no signs of inflammation  close follow up  did not show up again

13 Pathogenesis  Caused by infestation with toxocara canis, a common intestinal roundworm of dogs  Infection occurs secondary to ingestion of food contaminated with the ova shed in the dogs faeces  In the intestine the ova proliferate into larvae which penetrates the intestinal wall and spread to different organs like the eye

14 Ocular toxocariasis - 3 forms  Chronic endophthalmitis like picture  Posterior pole granuloma  Peripheral granuloma  Less common manifestations include: anterior uveitis, papillitis and localized vitreous abscess

15 Chronic endophthalmitis  Presentation: between 2 and 9 years of age with leukocoria, strabismus  ant. Uveitis  Vitritis  peripheral retina and pars plana: dense grey white exsudate similar to a snowbank  Complications: TRD and cataract  Prognosis: poor  Treatment: periocular steroids, surgery

16 Peripheral granuloma  Presentation: during adult life with visual impairment from macular distortion or RD  if uncomplicated it may remain asymptomatic, or  white hemispherical granuloma  anterior to the equator in any quadrant of the fundus  vitreous bands may extend from the lesion to the post. pole causing  dragging of the disc and straightening of the blood vessels

17 Posterior pole granuloma  Presentation: unilateral visual impairment  rounded yellow white solid granuloma  one to two discs in diameter  overlying the macula  occasionally may involve the disc  no uveitis  Complications: vascular distortions and exudations, subretinal haemorrhages and may be RD


Download ppt "Ahmed Y. Hatata, MSc Rowayda M. Amin, MSc Assistant Lecturer Ophthalmology Alexandria University, Egypt Toxocariasis."

Similar presentations


Ads by Google