PDF(Pubmed)
Abstract：
UNASSIGNED: This article aims to report a case of successful treatment of peripheral granulomatous ocular toxocariasis (OT) in an 8-year-old patient using intravitreal injection of dexamethasone (DEX) implant (Ozurdex) under ultrasound biomicroscopy (UBM) guidance.
UNASSIGNED: A previously healthy 8-year-old boy with a history of long-term close contact with dogs complained of blurring of vision in the right eye for a year. Ophthalmic examination of his right eye showed chronic uveitis. Notably, UBM examination identified granulomas and peripheral vitreous strand in the ciliary body from 3 to 8 o\'clock positions. Enzyme-linked immunosorbent assay (ELISA) results of the intraocular fluid (IF) and serum showed increased anti-Toxocara immunoglobulin G (IgG) levels, leading to a diagnosis of peripheral granulomatous OT in the right eye. Intraocular surgery was not indicated in this case. The treatment goal was to alleviate uveitis, improve visual acuity, and prevent complications. He was treated with an intravitreal injection of DEX implant, administered as a single dose every three months, total two doses, combined with albendazole, an oral anthelmintic. Under preoperative UBM guidance, two injections were performed at the 12 and 10 o\'clock positions in the pars plana where there were no granulomas and peripheral vitreous strand, successfully preventing complications associated with intravitreal injection. After two injections, the patient\'s right eye vision improved significantly, with the best-corrected visual acuity (BCVA) increasing from 20/400 to 20/50. Vitreous opacity and retinal edema were reduced, preretinal proliferative membrane was stabilized, and no adverse events occurred.
UNASSIGNED: UBM can accurately determine the location and extent of peripheral granulomas in OT patients, facilitating the avoidance of granulomas during intravitreal injection and preventing complications associated with intravitreal injection. Under the close follow-up and strict adherence to indications, preoperative UBM-guided intravitreal injections of DEX implant treatment for pediatric peripheral granulomatous OT are safe and effective, providing a new therapeutic option for pediatric peripheral granulomatous OT.
UNASSIGNED: A previously healthy 8-year-old boy with a history of long-term close contact with dogs complained of blurring of vision in the right eye for a year. Ophthalmic examination of his right eye showed chronic uveitis. Notably, UBM examination identified granulomas and peripheral vitreous strand in the ciliary body from 3 to 8 o\'clock positions. Enzyme-linked immunosorbent assay (ELISA) results of the intraocular fluid (IF) and serum showed increased anti-Toxocara immunoglobulin G (IgG) levels, leading to a diagnosis of peripheral granulomatous OT in the right eye. Intraocular surgery was not indicated in this case. The treatment goal was to alleviate uveitis, improve visual acuity, and prevent complications. He was treated with an intravitreal injection of DEX implant, administered as a single dose every three months, total two doses, combined with albendazole, an oral anthelmintic. Under preoperative UBM guidance, two injections were performed at the 12 and 10 o\'clock positions in the pars plana where there were no granulomas and peripheral vitreous strand, successfully preventing complications associated with intravitreal injection. After two injections, the patient\'s right eye vision improved significantly, with the best-corrected visual acuity (BCVA) increasing from 20/400 to 20/50. Vitreous opacity and retinal edema were reduced, preretinal proliferative membrane was stabilized, and no adverse events occurred.
UNASSIGNED: UBM can accurately determine the location and extent of peripheral granulomas in OT patients, facilitating the avoidance of granulomas during intravitreal injection and preventing complications associated with intravitreal injection. Under the close follow-up and strict adherence to indications, preoperative UBM-guided intravitreal injections of DEX implant treatment for pediatric peripheral granulomatous OT are safe and effective, providing a new therapeutic option for pediatric peripheral granulomatous OT.
摘要：
■本文旨在报告一例在超声生物显微镜（UBM）指导下，玻璃体内注射地塞米松（DEX）植入物（Ozurdex）成功治疗8岁患者周围肉芽肿性眼弓形虫病（OT）的病例。
■一个以前健康的8岁男孩，有与狗长期密切接触的历史，抱怨右眼视力模糊一年。右眼的眼科检查显示为慢性葡萄膜炎。值得注意的是,UBM检查发现3至8点睫状体中的肉芽肿和周围玻璃体链。眼内液（IF）和血清的酶联免疫吸附测定（ELISA）结果显示抗弓形虫免疫球蛋白G（IgG）水平升高，导致右眼周围肉芽肿OT的诊断。在这种情况下，不需要进行眼内手术。治疗目标是缓解葡萄膜炎,提高视力，预防并发症。他接受了玻璃体内注射DEX植入物的治疗，每三个月单剂量给药，总共两个剂量，联合阿苯达唑，口服驱虫药.在术前UBM指导下,在没有肉芽肿和周围玻璃体链的平坦部12点和10点位置进行了两次注射，成功预防与玻璃体内注射相关的并发症。两次注射后，患者的右眼视力明显改善，最佳矫正视力（BCVA）从20/400增加到20/50。玻璃体混浊和视网膜水肿减轻，视网膜前增殖膜稳定，无不良事件发生。
■UBM可以准确确定OT患者周围肉芽肿的位置和程度，有助于在玻璃体内注射期间避免肉芽肿，并预防与玻璃体内注射相关的并发症。在密切随访和严格遵守适应症的情况下，术前UBM引导下玻璃体腔注射DEX植入治疗小儿外周肉芽肿OT是安全有效的,为小儿外周肉芽肿OT提供新的治疗选择。
■一个以前健康的8岁男孩，有与狗长期密切接触的历史，抱怨右眼视力模糊一年。右眼的眼科检查显示为慢性葡萄膜炎。值得注意的是,UBM检查发现3至8点睫状体中的肉芽肿和周围玻璃体链。眼内液（IF）和血清的酶联免疫吸附测定（ELISA）结果显示抗弓形虫免疫球蛋白G（IgG）水平升高，导致右眼周围肉芽肿OT的诊断。在这种情况下，不需要进行眼内手术。治疗目标是缓解葡萄膜炎,提高视力，预防并发症。他接受了玻璃体内注射DEX植入物的治疗，每三个月单剂量给药，总共两个剂量，联合阿苯达唑，口服驱虫药.在术前UBM指导下,在没有肉芽肿和周围玻璃体链的平坦部12点和10点位置进行了两次注射，成功预防与玻璃体内注射相关的并发症。两次注射后，患者的右眼视力明显改善，最佳矫正视力（BCVA）从20/400增加到20/50。玻璃体混浊和视网膜水肿减轻，视网膜前增殖膜稳定，无不良事件发生。
■UBM可以准确确定OT患者周围肉芽肿的位置和程度，有助于在玻璃体内注射期间避免肉芽肿，并预防与玻璃体内注射相关的并发症。在密切随访和严格遵守适应症的情况下，术前UBM引导下玻璃体腔注射DEX植入治疗小儿外周肉芽肿OT是安全有效的,为小儿外周肉芽肿OT提供新的治疗选择。
