Ocular Toxocariasis: New Diagnostic and Therapeutic Perspectives

Abstract

Toxocariasis is still a problem of public health, particularly in developing countries with an increasing epidemiological burden in terms of morbidity and mortality and most of the authors agree on the utmost relevance of its prevention. Clinical experience and suspicion of ophthalmologists make an important role in its diagnosis, but always with supportive diagnostic methods. Additional studies should explore new therapeutic options for toxocariasis.

Ocular toxocariasis: atypical clinical course

“…The diagnosis of OT is presumptive because a definitive one requires actual demonstration of the larvae in the human eye 2 6. Thus, alternative investigations are used, including serum ELISA for the detection of Toxocara antibodies and western blot for the immunological diagnosis of OT 3 6.…”

“…The diagnosis of OT is presumptive because a definitive one requires actual demonstration of the larvae in the human eye 2 6. Thus, alternative investigations are used, including serum ELISA for the detection of Toxocara antibodies and western blot for the immunological diagnosis of OT 3 6. In nationwide surveys of T. canis infection in humans, the prevalence of serum antibodies is highly variable, ranging from 1% in Japan to 87% in school-aged children in the Marshall Islands 1.…”

“…In nationwide surveys of T. canis infection in humans, the prevalence of serum antibodies is highly variable, ranging from 1% in Japan to 87% in school-aged children in the Marshall Islands 1. Although human toxocariasis seroprevalence is variable, it is higher in rural environments, particularly in communities with close contact between humans and wild or domestic canids and felids due to contamination of soils and ingestion of contaminated products 1 6. No recent data are available on human seroprevalence of T. canis in Portugal; however, an epidemiological study assessed the prevalence of parasitic infection in faecal samples from three urban dog parks in Lisbon, and showed that 0.5% of them were contaminated with Toxocara spp 7…”

Ocular Parasitic Infections – An Overview

“…Various ocular clinical manifestations such as keratitis, hypopyon, iritis, uveitis, posterior pole granuloma, vitreous abscess and retinal detachment, strabismus, vision loss are attributed due to vitritis, cystoid macular edema and tractional retinal detachment [11,[202][203][204]. Based on clinical and physical examination, ocular toxocariasis is classified as chronic endophthalmitis, posterior granuloma and peripheral granuloma [205]. Approximately 25-50% of ocular toxocariasis patients present as posterior pole granuloma, due to lodging of the parasite in small perifoveal end-arteries, and approximately in 50% of ocular toxocariasis patients peripheral granuloma is present.…”

“…Acute lesion appears as hazy, white mass in the Advances in Common Eye Infections peripheral fundus that may mimic the appearance of snowbank seen in patients with pars planitis. High index of suspicion is required for establishing the diagnosis of OLM during ocular examination [205]. Marked eosinophilia along with positive serology by ELISA [206] helps in confirming the diagnosis [207].…”