薬物療法で鎮静化が得られた眼トキソカラ症の1例

Systemic medication was effective in a case of ocular toxocariasis

　仔犬との接触歴のある14歳女子が，1週間前からの左眼霧視と眼痛で受診した。矯正視力は左0,15で，左眼に硝子体索と周辺部眼底に黄白色の隆起性病変があった。血清のトキソカラ抗体が陽性であり，特徴的な眼所見と合わせ眼トキソカラ症と診断した。ステロイド薬の全身投与は無効であり，4週間後に視力が0.02に低下した。初診6週後からジエチルカルバマジンの全身投与を開始した後，病巣は急速に瘢痕化し，網膜浮腫と血管炎が著明に改善し，視力が0.6に回復した。薬物療法のみで眼トキソカラ症が改善しうることを示す症例である。

A 14-year-old girl presented with blurring and pain in her left eye sincelweek before. Her corrected visualacuity was 0.15 left. The affected eye showed vitreous strands and a granulomatous inflammatory mass in the peripheralretina. She was diagnosed with ocular toxocariasis after her serum proved to be positive for toxocara antibody.Initialtreatment with systemic corticosteroid was ineffective with the left visual acuity reduced to 0.02 4 weeks later. Systemic treatment with diethylcarbamazine was started 6 weeks after her initial visit. The granulomatous lesion underwent rapidscarring associated with resolution of retinal edema and vasculitis. The visual acuity has improved to 0.6. This caseillustrates that ocular toxocariasis may be effectively treated by systemic medication alone.