Cystoid macular edema and ocular toxocariasis in adult patients

Abstract

AbstractPurpose To report clinical features in proven ocular Toxocariasis in adult patients.Methods This retrospective study included 14 adults suffering from chronic uveitis whose clinical signs suggested an ocular toxocariasis, secondarely confirmed by semi‐quantitative western blot (WB) in aqueous or vitreous humor. The clinical characteristics and signs of uveitis had been analysed, especially : anterior chamber flare meter measurement, vitreous aspect, presence of retinal granuloma, retinal haemorrhages or cystoid macular edema.Results We had included 6 women and 8 men. The average age of patients at diagnosis was 45.6 years with an average time of diagnosis of 15.1 months. Uveitis was unilateral. All patients having a vitreous inflammation whose 11 also had a panuveitis. The main clinical signs observed were : one or more active focal deep whitish lesions in retinal periphery (78%), retinal hemorrhages (36%) or vitreoretinal tractions (64%). The main posterior segment complication observed was a chronic macular edema (71%). Patients had been followed during an average of 21.4 months.Conclusion Ocular toxocariasis could induce chronic unilateral posterior uveitis in adults. The presence of a vitreous cellular inflammation is consistenly found. While whitish peripheral granuloma and vitreoretinal tractions appear very suggestive, a chronic cystoid macular edema is found as main complication. This diagnosis could be delayed in atypical forms so aqueous humor and vitreous sampling for testing toxocariasis by semi‐quantitative WB remains still helpful.