Ocular angiostrongyliasis, diagnosed by identification of Angiostrongylus cantonensis in any part of the eye, is a very rare manifestation. We report seven cases of intraocular angiostrongyliasis in Srinagarind Hospital, Khon Kaen University, Thailand. From a total of 654 cases of angiostrongyliasis diagnosed between January 1995 and April 2005, 7 cases (1.1%) with ocular manifestations were found. Four men and three women were diagnosed, with a mean age of 32.1 years (range 21-46 years). All of the patients lived in the northeast of Thailand and acquired the infection by eating raw Pila spp. snails, the intermediate host of A. cantonensis. The incubation period lasted from 2 weeks to 2 months. The most common symptom, blurred vision without eosinophilic meningitis, occurred as a presenting symptom in five cases. The other two cases presented with eosinophilic meningitis prior to development of poor visual acuity. Both cases had papilloedema, neck stiffness and eosinophilia without fever. The visual acuity of the patient was mostly lower than 2/60 and, evidently, visual impairment in all patients was caused by retinal pigment epithelial defects. All cases had only one immature A. cantonensis worm in the eye, with the most common site being the intravitreous area. Several treatments, including oral prednisolone, topical prednisolone, argon laser, diode laser, Nd:YAG laser, surgical removal of the parasite and combination therapy, were used. There is no evidence that surgical and laser interventions improve the course of the disease, and both have associated risks. Visual outcome depends on the initial visual defects.
Purpose
To compare Thais’ health-related quality of life (HRQOL) and severity grading, efficacy and safety in daily-life-affected benign essential blepharospasm (BEB) patients at baseline and after Botulinum toxin type A (BTX-A) treatment.
Design
Prospective-observational study.
Participants
BEB patients with Jankovic rating scale (JRS) at least 3 in both severity and frequency graded from 14 institutes nationwide were included from August 2020 to June 2021.
Methods
Demographic data, HRQOL evaluated by the Thai version of EQ-5D-5L and NEI-VFQ-25 questionnaires, and severity grading score evaluated by Jankovic rating scale (JRS) at baseline, 1, and 3 months after the treatment were collected. The impact of the BTX-A injections and their complications were recorded.
Results
184 daily-life-affected BEB patients were enrolled; 159 patients (86.4%) had complete data with a mean age of 61.40±10.09 years. About 88.05% were female, and 10.1% were newly diagnosed. Most of the patients had bilateral involvement (96.9%) and 12.6% had history of BEB-related accident. After BTX-A treatment, HRQOL improved significantly in 4 dimensions of EQ-5D-5L, except self-care. The EQ_VAS (mean±SD) was 64.54±19.27, 75.13±15.37, 73.8±15.85 (p<0.001) and EQ-5D-5L utility score was 0.748±0.23, 0.824±0.19 and 0.807±0.19 at baseline, 1, 3 months after treatment, respectively. From NEI-VFQ-25, HRQOL also improved in all dimensions, except eye pain. The JRS improved in all patients. Self-reported minor adverse events were 22.6%, which mostly resolved within the first month.
Conclusion
Daily-life-affected BEB impacted HRQOL in most dimensions from both generic and visual-specific questionnaires. BTX-A treatment not only decreased disease severity, but also improved quality of life.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.