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T. Higashide, N. Akao, E. Shirao, Y. Shirao; Angiographic and Optical Coherence Tomographic (OCT) Features of Presumed Toxocara Granuloma in Adult Macula . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4910.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To characterize presumed Toxocara granuloma in the adult macula by angiography and optical coherence tomography (OCT). Methods: Three consecutive adult patients with unilateral exudative macular lesions and positive results of serum ELISA assay for Toxocara larval antigens were examined by OCT and fluorescein and indocyanine green angiography (FA and IA, respectively). Results: Antibodies to Toxocara canis or T. cati were detected in all of the three patients’ sera. At the initial examination, all lesions showed dye leakage on FA. Two fresh lesions were accompanied by hyperfluorescence of the optic disc. In IA, the fresh lesions were hypofluorescent and the chronic lesion had inner reticular hyperfluorescence. Hypofluorescent spots on IA were observed in the macula in one case with a fresh lesion. OCT depicted the macular lesions as a fusiform thickening of the retinal pigment epithelium (RPE)/choriocapillaris layer or a mass protruding into the subretinal space. After systemic steroid and anthelminthic therapy, the fresh macular lesions had decreased fluorescein leakage on FA and showed reticular hyperfluorescence surrounded by a dark rim on IA. OCT demonstrated that the fresh lesions were smaller and covered by the RPE. The chronic lesions showed no improvement despite medication. Conclusions: The macular lesions resembled those of idiopathic choroidal neovascularization in OCT and angiography, and thus presumed Toxocara granuloma should be included in the differential diagnosis of idiopathic choroidal neovascularization.
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