前房穿刺により早期に診断された眼犬蛔虫症

Aqueous cytology led to early diagnosis in a case of ocular toxocariasis

　前房細胞診にて，多数の好酸球が証明されたことにより，眼犬蛔虫症を疑い，免疫血清学的所見と臨床所見にて確定診断ができたぶどう膜炎の症例を報告した。

　眼犬蛔虫症では，末梢血に好酸球増多を認めなくても，前房中に好酸球遊出を認めることがあるので，前房細胞診が早期診断，および鑑別診断に有効である。

A 54-year-old male presented with acute iridocy-clitis in the right eye of 1 weeks' duration. A large keratitic precipate and diffuse vitreous opacity were present. Two isolated yellowish-white exudates were present in the retina near the disc. We aspirated the aqueous from the anterior cham-ber. Electron microscopy of the aspirate showed numerous eosinophils, suggesting the possibility of ocular toxocariasis. Immunoserological tests were positive for egg antigens and larval antigens of Toxocara canis. Treatment with systemic diethyl-carbamazine and prednisolone resulted in reduction of inflammation. The present case illustrates that eosinophils may be present in the anterior chamber and absent in the circulating blood in ocular tox-ocariasis. Aqueous cytology will be a useful means in establishing the diagnosis.