PMC3934803_01
A fundus photograph shows vitreous opacities and yellowish-white intraretinal lesions in the inferotemporal region of the optic disc with papilloedema at the first visit (a), resolution of the vitreous opacity and inflammatory changes at the foci 1 month after anthelmintic and steroid therapies (b), and recurrence of the primary lesion with two additional yellowish-white retinal lesions and vitreous flare 3 months after treatment (c). d These lesions were finally controlled with anthelmintic and steroid therapies after 2 months.
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F1
The fundus examination showed (1+) vitreous opacities, (2+) vitreous cells, phlebitis, moderate disc swelling, reddening, yellowish-white retinal lesions in the inferotemporal region of the optic disc, and a white exudative lesion near the inferior arcade (fig. 1a). It was alleviated because the exudative lesion was dried out with treatments after 1 month (fig. 1b). However, 3 months after treatment initiation, the toxocariasis recurred during a treatment-free period (fig. 1c). Anthelmintic albendazole (ALBENZA 800 mg twice daily) and oral steroids (initial dose 20 mg/day) were resumed, and the infectious lesions were controlled gradually after another 2 months (fig. 1d).
Serology ELISA data for T. canis. The antibody titer deceased after therapy. OD405: optical density at 405 nm.
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F2
Examination of the patient's serum for antibody to T. canis larvae by ELISA showed an elevated antibody level (fig. 2). OCT within the following 8 months (fig. 3b, f). One year after the therapy, signs of inflammation and the elevated retinal lesion had disappeared along with the reduction of blood anti- Toxocara canis antibody titer (fig. 2).
A fundus photograph and optical coherence tomography images show a white intraretinal lesion (arrowhead, a) protruding from the retinal surface into the vitreous (a, e), resolution with anthelmintic and steroid therapies within the next 8 months (b, f), recurrence with a protruding retinal lesion (arrowhead, c) after 4 months (c, g), and resolution without active inflammation 2 months after anthelmintic monotherapy (d, h).
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F3
Two months after the retreatment was terminated, an intraretinal lesion was observed protruding from the retinal surface into the vitreous cavity (fig. 3a). Examination of this site by HP-OCT confirmed an elevated lesion protruding from the inner retina to the vitreous cavity (fig. 3e). OCT within the following 8 months (fig. 3b, f). One year after the therapy, signs of inflammation and the elevated retinal lesion had disappeared along with the reduction of blood anti- Toxocara canis antibody titer (fig. 2). Unexpectedly, after 4 months, the elevated lesion reappeared (fig. 3c, g) and anthelmintic monotherapy (800 mg twice daily) was resumed, resulting in lesion control after 2 months (fig. 3d, h).