Ocular Toxocariasisに対する硝子体手術

Pars plana vitrectomy for ocular toxocariasis

　臨床症状および免疫学的検索により眼寄生虫症が疑われた7眼に対して硝子体手術を行い，術中に採取した硝子体に対し免疫学的検索を行った。7眼のうち6眼は網膜剥離併発例，1眼はステロイド療法に抵抗する硝子体混濁例であった。最終的に6眼中5眼に網膜の復位を，1眼に硝子体混濁の改善をえた。7眼全例に視力予後の改善をみた。硝子体手術の意義は硝子体切除による中間透光体の再建と免疫複合体などの炎症起因物質の除去，網膜に対する牽引の解除，増殖塊の瘢痕形成促進などである。ステロイド剤の投与に抵抗する症例，牽引性網膜剥離，裂孔併発型牽引性網膜剥離など黄斑部の不可逆的変化が心配される症例に対しては診断学的意味も含めて積極的に硝子体手術を施行すべきである。

We treated 7 eyes with presumed ocular toxocar-iasis by pars plana vitrectomy during the foregoing 4-year period. All the eyes were characterized by the presence of fibrovascular mass in the peripheral fundus. Unilateral involvement was the rule. Retinal detachment was present in all the cases:rhegmatogenous in 5 and traction-induced in 2 eyes. Vitreous opacity was the outstanding feature in 1 eye. Vitrectomy was followed by improvement in visual acuity in all the eyes. ELISA test was performed in all the vitreous samples and proved positive in all. Vitrectomy was thus useful in treat-ing tractional macular detagement and vitreous opacity nonresponsive to corticosteroid. It was also helpful in establishing definitive diagnosis through immunological methods.