Purchase this article with an account.
R. Jimenez, L. Wu, J. Martinez; Ocular Toxocariasis in Costa Rica During 1998-2008: A Ten Year Review. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6022.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To report the demographics, clinical findings, treatment and visual outcome of eighty pediatric patients diagnosed with ocular toxocariasis in Costa Rica during the past 10 years.
The clinical records of all the patients diagnosed with ocular toxocariasis at the Hospital Nacional de Niños, San José, Costa Rica, between March 1998 and March 2008 were reviewed retrospectively.
During the ten years, eighty cases of ocular toxocariasis were diagnosed, with a mean incidence of 8 cases per year. Mean age was 6.8 years (standard deviation, 2.9; range 1-15); 63.8% were males. All cases were unilateral. Strabismus (37.5%), visual impairment (33.8%) and leucocoria (16.3%) were the most common symptoms. At baseline, 2.5% presented with a visual acuity of ≥ 20/40, 5% between 20/50 and 20/100 and 92.5% were ≤ 20/200. The most common anterior segment findings were: cataract (21.3%), posterior synechiae (21.3%) and band keratopathy (10%). Among the eighty patients, 73.8% presented with some degree of vitreitis, ranging from very mild to severe. A retinal granuloma was visible in 80% of cases, in 13.8% of patients a granuloma was not found, and 6.2% had severe vitreitis precluding fundoscopy. Tractional retinal detachment was present in 45% of patients. Toxocara serum ELISA was positive in 98.6% of the cases. Eosinophilia was present in 58.8% of the patients. Among all the cases, 36.2% received no treatment, 35% received only medical treatment with thiabendazole and/or steroids, and 28.8% underwent a pars plana vitrectomy alone or combined with medical treatment. Follow-up information was available for 54 patients. At the last follow-up, 18.5% were ≥ 20/40, 13.0% between 20/50 and 20/100 and 68.5% were ≤ 20/200. The average follow-up was of 18 months (range 1 - 78 months).
Ocular toxocariasis is an important infectious cause of unilateral uveitis and visual impairment in children in Costa Rica. It presents with poor visual acuity at the initial visit and has a poor visual prognosis.
This PDF is available to Subscribers Only